Neurocognition and Treatment Outcomes in Schizophrenia

Abstract

Neurocognitive deficits affect nearly every aspect of psychosocial and functional outcomes in schizophrenia. In particular, deficits to executive functioning and verbal memory have been found to predict clinical and psychosocial outcomes at every stage of the psychosis spectrum, from clinically high-risk populations to chronic schizophrenia. Baseline cognitive indices provide clinical and prognostic information about daily functioning, community integration, and quality of life and can serve as predictors of health-care-related outcomes as well. While psychotic symptoms of schizophrenia are amenable to pharmacologic interventions, treatment strategies for cognitive symptoms are lacking. From a drug discovery perspective, modulation of glutamatergic and cholinergic pathways is promising, but there are no current FDA-approved medications for the treatment of cognitive symptoms in schizophrenia. As therapeutic options for this disorder continue to grow, including pharmacology, neuromodulation, cognitive remediation, and combinations thereof, these treatments will be made particularly potent if they are applied to biomarker-identified sensitive subgroups of patients.