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Association between treatment resistance and cognitive function in schizophrenia.
Jiaqian Sun1, Jie Yin Yee1, Yuen Mei See1
1North Region, Institute of Mental Health, Singapore.
Singapore Medical Journal
|October 8, 2024
Summary
Cognitive impairment in schizophrenia worsens with increased treatment resistance. Patients with ultra-treatment-resistant schizophrenia (UTRS) showed poorer cognitive function compared to those responsive to antipsychotics or clozapine.
Area of Science:
- Neuroscience
- Psychiatry
- Cognitive Science
Background:
- Treatment-resistant schizophrenia (TRS) affects approximately 30% of schizophrenia patients.
- A significant portion of TRS patients are resistant even to clozapine treatment.
- The relationship between cognitive function and treatment resistance levels is not well-understood.
Purpose of the Study:
- To investigate cognitive performance across different schizophrenia treatment response subgroups.
- To determine if cognitive impairment correlates with the degree of treatment resistance.
Main Methods:
- Study included healthy controls, antipsychotic-responsive schizophrenia (ARS), clozapine-responsive TRS (TRS-CR), and clozapine-resistant TRS (UTRS) groups.
- Cognitive function was assessed using the Brief Assessment of Cognition-Short Form.
- Statistical analyses adjusted for age, sex, PANSS scores, and antipsychotic dose.
Main Results:
- Significant differences in cognitive performance were observed across groups, with ARS showing the least impairment, followed by TRS-CR and UTRS.
- Poorer cognitive function was directly associated with higher levels of treatment resistance.
- Antipsychotic dose, and PANSS negative and disorganisation/cognitive factors predicted overall cognitive function.
Conclusions:
- Cognitive function declines as treatment resistance in schizophrenia increases.
- Targeting negative and disorganisation symptoms may improve cognitive function and treatment outcomes in schizophrenia.
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