Download PDF
psychoneuro 2008; 34(10): 457-460
DOI: 10.1055/s-0028-1103114
Schwerpunkt

© Georg Thieme Verlag Stuttgart · New York

Kognitive Beeinträchtigung und Alltagsfunktion bei an Schizophrenie erkrankten Patienten – Entscheidende Faktoren für den Langzeitverlauf

Cognitive impairment and functional level in schizophrenic patients – Determining factors for the long–term courseGeorg Adler1
  • 1Institut für Studien zur Psychischen Gesundheit (ISPG), Mannheim
Further Information

Publication History

Publication Date:
05 November 2008 (online)

    Permissions and Reprints

Kognitive Störungen treten bei schizophren kranken Menschen häufig auf und betreffen vor allem Arbeitsgedächtnis, exekutive Funktionen, Aufmerksamkeitsleistungen und episodisches deklaratives Gedächtnis. Diese kognitiven Störungen haben entscheidende Bedeutung für das Funktionsniveau, den Langzeitverlauf und die Rehabilitation schizophren kranker Menschen. Auf neurobiologischer Ebene sind die kognitiven Störungen schizophren kranker Menschen mit einem dopaminergen Defizit im Bereich des präfrontalen Kortex verbunden.

Cognitive impairments are frequent in schizophrenic patients and mainly affect working memory, executive functions, attention and episodic declarative memory. These cognitive impairments are of crucial importance for functional level, long–term course and rehabilitation of schizophrenic patients. On a neurobiological level, cognitive impairments in schizophrenic patients are related to a dopaminergic deficit in the prefrontal cortices.

Key words

Schizophrenia - memory - executive functions - attention - functional level

Literatur

  • 1 Aleman A, Hijman R, de EH Haan, Kahn RS.. Memory impairment in schizophrenia: a meta–analysis.  Am J Psychiatry. 1999;  156 1358-1366
    PubMedGoogle Scholar
  • 2 Arnsten AF, Goldman–Rakic PS.. Noise stress impairs prefrontal cortical cognitive function in monkeys: evidence for a hyperdopaminergic mechanism.  Arch Gen Psychiatry. 1998;  55 362-368
    CrossrefPubMedGoogle Scholar
  • 3 Arnsten AF, Cai JX, Murphy BL, Goldman–Rakic PS.. Dopamine D1 receptor mechanisms in the cognitive performance of young adult and aged monkeys.  Psychopharmacology (Berl). 1994;  116 143-151
    CrossrefPubMedGoogle Scholar
  • 4 Berman I, Viegner B, Merson A. et al. . Differential relationships between positive and negative symptoms and neuropsychological deficits in schizophrenia.  Schizophr Res. 1997;  25 1-10
    CrossrefPubMedGoogle Scholar
  • 5 Braff DL, Heaton R, Kuck J. et al. . The generalized pattern of neuropsychological deficits in outpatients with chronic schizophrenia with heterogeneous Wisconsin Card Sorting Test results.  Arch Gen Psychiatry. 1991;  48 891-898
    CrossrefPubMedGoogle Scholar
  • 6 Braff DL.. Information processing and attention dysfunctions in schizophrenia.  Schizophr Bull. 1993;  19 233-259
    PubMedGoogle Scholar
  • 7 Brébion G, Amador X, Smith M. et al. . Depression, psychomotor retardation, negative symptoms, and memory in schizophrenia.  Neuropsychiatry Neuropsychol Behav Neurol. 2000;  13 177-183
    PubMedGoogle Scholar
  • 8 Buchsbaum MS, Hazlett EA.. Positron emission tomography studies of abnormal glucose metabolism in schizophrenia.  Schizophr Bull. 1998;  24 343-364
    PubMedGoogle Scholar
  • 9 Bymaster FP, Felder C, Ahmed S, McKinzie D.. Muscarinic receptors as a target for drugs treating schizophrenia.  Curr Drug Targets CNS Neurol Disord. 2002;  1 163-181
    CrossrefPubMedGoogle Scholar
  • 10 Callicott JH, Mattay VS, Verchinski BA. et al. . Complexity of prefrontal cortical dysfunction in schizophrenia: more than up or down.  Am J Psychiatry. 2003;  160 2209-2215
    CrossrefPubMedGoogle Scholar
  • 11 Castner SA, Goldman–Rakic PS, Williams GV.. Animal models of working memory: insights for targeting cognitive dysfunction in schizophrenia.  Psychopharmacol (Berl). 2004;  174 111-125
    PubMedGoogle Scholar
  • 12 Cornblatt BA, Erlenmeyer–Kimling L.. Global attentional deviance as a marker of risk for schizophrenia: specificity and predictive validity.  J Abnorm Psychol. 1985;  94 470-478
    CrossrefPubMedGoogle Scholar
  • 13 Crow TJ, Done DJ, Sacker A.. Childhood precursors of psychosis as clues to its evolutionary origins.  Eur Arch Psychiatry Clin Neurosci. 1995;  245 61-69
    CrossrefPubMedGoogle Scholar
  • 14 Cummings JL.. Frontal–subcortical circuits and human behavior.  Arch Neurol. 1993;  50 873-880
    CrossrefPubMedGoogle Scholar
  • 15 Friedman JI, Temporini H, Davis KL.. Pharmacologic strategies for augmenting cognitive performance in schizophrenia.  Biol Psychiatry. 1999;  45 1-6
    CrossrefPubMedGoogle Scholar
  • 16 Friedman JI, Harvey PD, Coleman T. et al. . Six–year follow–up study of cognitive and functional status across the lifespan in schizophrenia: a comparison with Alzheimer's disease and normal aging.  Am J Psychiatry. 2001;  158 1441-1448
    CrossrefPubMedGoogle Scholar
  • 17 Gold JM, Randolf C, Carpenter C. et al. . Forms of memory failure in schizophrenia.  J Abnorm Psychol. 1992;  101 487-494
    CrossrefPubMedGoogle Scholar
  • 18 Goldberg TE, Saint–Cyr JA, Weinberger DR.. Assessment of procedural learning and problem solving in schizophrenia patients by Tower of Hanoi type tasks.  J Neuropsychiatry Clin Neurosci. 1990;  2 165-173
    PubMedGoogle Scholar
  • 19 Green MF.. What are the functional consequences of neurocognitive deficits in schizophrenia?.  Am J Psychiatry. 1996;  153 321-330
    CrossrefPubMedGoogle Scholar
  • 20 Green MF, Kern RS, Braff DL, Mintz J.. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the ”right stuff„?.  Schizophr Bull. 2000;  26 119-136
    Google Scholar
  • 21 Hegarty JD, Baldessarini RJ, Tohen M. et al. . One hundred years of schizophrenia: a meta–analysis of the outcome literature.  Am J Psychiatry. 1994;  151 1409-1416
    PubMedGoogle Scholar
  • 22 Hemsley DR.. A cognitive model and its implications for psychological intervention.  Behav Modif. 1996;  20 139-169
    PubMedGoogle Scholar
  • 23 Knapp M, Mangalore R, Simon J.. The global costs of schizophrenia.  Schizophr Bull. 2004;  29 279-293
    PubMedGoogle Scholar
  • 24 Kompetenznetz Schizophrenie (2005), unter www.kompetenznetz-schizophrenie.de/rdkns/22_25.htm (Stand: 18.10.2005). 
    Google Scholar
  • 25 Kurtz MM, Moberg PJ, Ragland JD. et al. . Symptoms versus neurocognitive test performance as predictors of psychosocial status in schizophrenia: a 1– and 4–year prospective study.  Schizophr Bull. 2005;  31 167-174
    CrossrefPubMedGoogle Scholar
  • 26 Lehman AF, Goldberg R, Dixon LB. et al. . Improving employment outcomes for persons with severe mental illness.  Arch Gen Psychiatry. 2002;  59 165-172
    PubMedGoogle Scholar
  • 27 Lewis DA, Pierri JN, Volk DW. et al. . Altered GABA neurotransmission and prefrontal cortical dysfunction in schizophrenia.  Biol Psychiatry. 1999;  46 616-626
    CrossrefPubMedGoogle Scholar
  • 28 Liddle PF.. Cognitive Impairment in schizophrenia: its impact on social functioning.  Acta Psychiatr Scand Suppl. 2000;  400 11-16
    PubMedGoogle Scholar
  • 29 Meltzer HY.. Treatment of suicidality in schizophrenia.  Ann N Y Acad Sci. 2001;  932 44-58
    PubMedGoogle Scholar
  • 30 Mirza NR, Peters D, Sparks RG.. Xanomeline and the antipsychotic potential of muscarinic receptor subtype selective agonists.  CNS Drug Rev. 2003;  9 159-186
    PubMedGoogle Scholar
  • 31 Nuechterlein KH.. Childhood precursors of adult schizophrenia.  J Child Psychol Psychiatry. 1986;  27 133-144
    CrossrefPubMedGoogle Scholar
  • 32 Saykin AJ, Shtasel DL, Gur RE. et al. . Neuropsychological deficits in neuroleptic naive patients with first–episode schizophrenia.  Arch Gen Psychiatry. 1994;  51 124-131
    CrossrefPubMedGoogle Scholar
  • 33 Spitzer M.. The psychopathology, neuropsychology, and neurobiology of associative and working memory in schizophrenia.  Eur Arch Psychiatry Clin Neurosci. 1993;  243 57-70
    PubMedGoogle Scholar
  • 34 Sullivan EV, Shear PK, Zipursky RB. et al. . Patterns of content, and working memory impairments in schizophrenia and nonamnesic alcoholism.  Neuropsychology. 1997;  11 195-206
    CrossrefPubMedGoogle Scholar
  • 35 Trestman RL, Keefe RS, Mitropoulou V. et al. . Cognitive function and biological correlates of cognitive performance in schizotypal personality disorder.  Psychiatry Res. 1995;  59 127-136
    CrossrefPubMedGoogle Scholar
  • 36 Voruganti LN, Heslegrave RJ, Awad AG.. Neurocognitive correlates of positive and negative syndromes in schizophrenia.  Can J Psychiatry. 1997;  42 1066-1071
    PubMedGoogle Scholar
  • 37 Williams GV, Rao SG, Goldman–Rakic PS.. The physiological role of 5–HT2A receptors in working memory.  J Neurosci. 2002;  22 2843-2854
    PubMedGoogle Scholar
  • 38 Young DA, Davila R, Scher H.. Unawareness of illness and neuropsychological performance in chronic schizophrenia.  Schizophr Res. 1993;  10 117-124
    CrossrefPubMedGoogle Scholar
  • 39 Zakzanis KK, Heinrichs RW.. Schizophrenia and the frontal brain: a quantitative review.  J Int Neuropsych Soc. 1999;  5 556-566
    CrossrefPubMedGoogle Scholar

Korrespondenz

Prof. Dr. med. Georg Adler

Institut für Studien zur Psychischen Gesundheit (ISPG)

Friedrichsplatz 12

68165 Mannheim

Email: adler@ispg-mannheim.de

      >