What Dimensions of Heterogeneity Are Relevant for Treatment Outcome?
What Dimensions of Heterogeneity Are Relevant for Treatment Outcome?
Schizophrenia is a disorder, or a class of disorders, of cognition. Defining features include a loss of coordination in core perception, attention, memory, and executive functions together with the dysregulation of emotion. These features are the strongest contributors to burden of illness. Diagnostic criteria, clinical trials, and popular conceptions typically focus, however, on the more florid positive symptoms of psychosis, such as hallucinations. As a result, impairments in cognitive–emotional function remain largely undiagnosed and untreated, with no current treatments in routine use that target these impairments. The evidence base for developing new treatments requires cognitive–emotional measures that link to functional capacity as well as to brain changes involved in schizophrenia pathophysiology. This chapter looks at five aspects of cognitive–emotional function in schizophrenia: Which cognitive–emotional impairments characterize schizophrenia patients at first onset? Are functional capacities predicted by these impairments at first onset? What brain systems are involved? How do cognitive–emotional impairments, and their relationships with functional capacity and brain function, progress over time? What are the implications for treatment outcomes? Focus is on the first episode of schizophrenia, since early intervention is likely to have the best impact for improving outcomes. Published in the Strungmann Forum Reports Series.
Keywords: Schizophrenia, Cognition, Emotion, Treatment, First Episode, Functional Capacity, Outcome, Cognitive Neuroscience
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