Browsing by Subject "ensipsykoosi"
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(2017)Objectives: Schizophrenia and other psychotic disorders are serious mental illnesses characterized by positive, negative and disorganized symptoms. In addition to the aforementioned symptom types, psychotic disorders are associated with a wide array of cognitive deficits. Cognitive functioning has been found to deteriorate already during the prodromal phase preceding the onset of a psychotic disorder. In schizophrenia, the level of severity of cognitive deficits has been found to become settled fairly quickly after the onset of illness. During the last few decades, a form of neuropsychological rehabilitation called cognitive remediation therapy has been developed for the alleviation of cognitive deficits associated with psychotic disorders. The aim of this review is to examine whether cognitive remediation therapy is an effective form of rehabilitation for people at risk for psychosis, patients with first episode psychosis and patients in the early course of schizophrenia or other psychotic disorders. The effectiveness of cognitive remediation therapy is evaluated in terms of its capabilities to alleviate cognitive deficits and enhance functioning. Methods: The material for this review consists of research articles retrieved from Scopus. The article searches were conducted using various combinations of the following search terms: cognitive remediation, schizophrenia, psychosis, first episode, early course, high risk, prodrom* and premorbid. Two systematic reviews, one combined meta-analysis and systematic review and three original research reports were included in this review. Results: Cognitive remediation therapy has been shown to enhance the cognitive functioning of patients in the early course of psychotic disorders and patients with recent onset psychosis. Positive effects on patients’ functioning have also been found, and alleviation of other symptoms of psychotic disorders due to cognitive remediation therapy has been reported in some studies. Few studies have examined the effectiveness of cognitive remediation therapy for people at risk for psychosis, but current evidence tentatively suggests that this population could also benefit from the treatment. Future studies should investigate how different kinds of cognitive remediation therapy affect different aspects of cognition and functioning, what kinds of factors explain the effects of the treatment and how cognitive remediation therapy could be tailored to the needs of different groups and individuals.
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(2019)Schizophrenia is a severe and often chronic disease, which causes substantial harm both to the individual and to the whole society by large. Schizophrenia has long been associated with widespread anatomical alterations in the brain, with the most extensive changes occurring during the first psychosis. More studies have also increasingly focused on whether any alterations are already noticeable before the psychosis. Knowing this enable to both start the treatment earlier, thereby improving the prognosis, and to develop novel, preventive treatments. The articles included in this review consist of longitudinal magnetic resonance imaging studies which compare the brain anatomy of inviduals with a high-risk of schizophrenia making the transition to psychosis or not. The review includes both genetic and clinical high-risk populations, with most of the articles included focusing on the latter. Taken together, the articles create a mostly consistent picture of the anatomical features of the brain associated with the transition to disease both before and during the psychosis. The amount of grey matter was found to be systemically lower and/or to reduce more rapidly than in normal population, especially in the prefrontal, parietal and temporal lobes, cerebellum and cingulate and insular cortexes. However, the whole brain volume was found to be increased. Also, the enlargement of the third ventricle was quite strongly associated with the transition to psychosis. Finally, the integrity and the amount of the white matter might have some connection to the transition, but the results are inconclusive. Based on the results, schizophrenia is associated with wide alterations in brain anatomy even before the first psychosis. It can be assumed that these alterations explain the symptoms of the disease, for example that the changes in the prefrontal cortex relate to the loss of cognitive ability. Better understanding the connection of brain anatomy to the symptoms and progress of schizophrenia enables more effective and earlier treatment.
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(2018)Objectives: Research has shown that cognitive deficits are a significant part of schizophrenia. Patients with schizophrenia show poorer performance in multiple areas of cognition such as memory functions, processing speed and executive functions. This review focuses to examine the range of specific executive function deficits in first-episode schizophrenia and how these deficits change during 1-3 year follow up period. Furthermore, the review focuses on viewing whether executive functioning is related to clinical profile, clinical outcome or functional outcome. Methods: The research was executed as a literature review. Search of literature was focused to executive functioning in adult first-episode schizophrenia. The following keywords were used in google scholar and Helka finna databases: ”first episode schizophrenia”, ”schizophrenia” combined with keywords ”executive functions”, ”cognitive functions” and ”cognitive deficits”. Keyword “outcome” was combined with the previous when searching for outcome articles. Some of the articles used were found from other research articles and they were included in the review if they met the same inclusion criteria. Results and conclusions: First-episode schizophrenics showed broad executive function deficits in multiple specific areas of function. Problems were systematically seen in working memory, cognitive flexibility, fluency, inhibition and planning. In addition, there were conflicting results about attention allocation and initiation. Executive deficits did not seem to change drastically during a 1-3 year follow up period, but cognitive flexibility skills were assessed to improve in multiple studies. Moreover, research shows that negative and disorganization symptoms relate to executive dysfunction. Several studies considering relation between executive function and outcome show that there is a link between executive functioning and functional outcome. Studies considering clinical outcome were conflicted and certain conclusions cannot yet be drawn. However, it seems that planning abilities might be related to clinical outcome but there is a need for further study.
Now showing items 1-3 of 3