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The relationship between cognition and functioning in schizophrenia: A semi-systematic review
Saifuddin Kharawala1, Claudia Hastedt2, Jana Podhorna2
1Bridge Medical Consulting Ltd., 2 Marsault Court, 11 Kew Foot Road, Richmond TW9 2SS, United Kingdom.
Schizophrenia Research. Cognition
|October 11, 2021
Summary
In schizophrenia, both neurocognition and social cognition significantly impact functional capacity and real-world functioning. Interventions combining cognitive remediation with psychosocial rehabilitation show promise for improving community functioning.
Area of Science:
- Psychiatry
- Neuroscience
- Rehabilitation Medicine
Background:
- Impairments in neurocognition (NC) and social cognition (SC) are core features of schizophrenia.
- These cognitive deficits are linked to reduced functional capacity (FC) and poor real-world functioning (RWF).
Purpose of the Study:
- To systematically review the association between NC, SC, and functioning in schizophrenia.
- To explore factors influencing these relationships and implications for treatment.
Main Methods:
- Semi-systematic review of Embase and MEDLINE databases (2005-2019) with additional searches.
- Inclusion of 44 prioritized citations (primary studies, systematic reviews, narrative reviews) from 564 screened.
- Analysis of associations between cognitive domains and various measures of functioning.
Main Results:
- Both NC and SC are significantly associated with FC and RWF, with SC showing a slightly stronger link.
- NC is more strongly linked to occupational and independent living, while SC relates more to social functioning.
- Cognitive remediation, especially combined with psychosocial rehabilitation, improves RWF; SC mediates NC's effect on functioning.
Conclusions:
- Both neurocognition and social cognition are crucial targets for improving functioning in schizophrenia.
- Adjunctive psychosocial rehabilitation enhances the benefits of cognitive interventions.
- Understanding mediating/moderating factors and appropriate outcome measures is vital for intervention development.
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