Cognitive Impairment in Schizophrenia

Cognitive functioning is moderately to severely impaired in patients with schizophrenia. This impairment is the prime driver of the significant disabilities in occupational, social, and economic functioning in patients with schizophrenia and an important

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Contents 1 Cognitive Impairment in Schizophrenia and Its Clinical Relevance . . . . . . . . . . . . . . . . . . . . . . . 1.1 Cognition in the Diagnosis of Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2 Cognitive Deficits Are Found in Almost All Patients with Schizophrenia . . . . . . . . . . 1.3 Cognitive Impairment Is Not Caused by Psychotic Symptoms . . . . . . . . . . . . . . . . . . . . . . 1.4 Cognitive Impairment Is an Important Cause of Functional Disability and Related Outcomes in Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.5 The Profile of Cognitive Impairment in Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.6 Cognitive Impairment Precedes the Onset of Psychosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.7 Assessment of Cognition in Schizophrenia Treatment Studies . . . . . . . . . . . . . . . . . . . . . . 1.8 Early Phase Trials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.9 Functional Capacity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Treatments for Cognitive Impairment in Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1 Antipsychotic Effects on Cognition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 Pharmacological Augmentation as a Cognitive Enhancement Strategy . . . . . . . . . . . . . 2.3 Results of Cognitive Enhancement Efforts to Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.4 Cognitive Remediation as a Platform for Pharmacologic Studies . . . . . . . . . . . . . . . . . . . 3 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Abstract Cognitive functioning is moderately to severely impaired in patients with schizophrenia. This impairment is the prime driver of the significant disabilities in occupational, social, and economic functioning in patients with schizophrenia and an important treatment target. The profile of deficits in schizophrenia includes many of the most important aspects of human cognition: attention, memory, reasoning,

R.S.E. Keefe (*) Duke University Medical Center, Durham, NC 27710, USA e-mail: [email protected] P.D. Harvey University of Miami Miller School of Medicine, Miami, FL 33136, USA e-mail: [email protected] M.A. Geyer and G. Gross (eds.), Novel Antischizophrenia Treatments, Handbook of Experimental Pharmacology 213, DOI 10.10