摘要
Cognitive deficits are now recognized widely as core features of schizophrenia, and as major contributors to the clinical outcome of the disorder. They are also studied widely as 'endophenotypes', reflecting a growing consensus that schizophrenia is a broader, more multidimensional illness than the diagnostic criteria required for its formal diagnosis. This evolving view of cognition underlies its utilization in recent initiatives for intervention and assessment in schizophrenia. Two of these initiatives are reviewed in this paper. The first focuses on the development and validation of the MATRICS Cognitive Consensus Battery, a standardized battery of neuropsychological tests developed to assess the effectiveness of cognitive enhancing treatments in schizophrenia. A part of this effort includes the identification of performance-based, 'co-primary' measures of functional capacity that are related to cognition, and that are likely to show improvement at least partly as a function of improved cognition. The second initiative involves efforts to utilize neuropsychological deficits in the identification, validation and remediation of a liability syndrome for schizophrenia ('schizotaxia'). The discussion of this effort focuses on the development of a syndrome that is both measurable and meaningful clinically, and that may provide useful intervention targets. The utilization of cognition in both of these initiatives underscores its functional importance in the clinical outcome of schizophrenia. Moreover, it helps to illuminate indicators of liability for schizophrenia that might be amenable to remediation.
Cognitive deficits are now recognized widely as core features of schizophrenia, and as major contributors to the clinical outcome of the disorder. They are also studied widely as ＇endophenotypes＇, reflecting a growing consensus that schizophrenia is a broader, more multidimensional illness than the diagnostic criteria required for its formal diagnosis. This evolving view of cognition un- derlies its utilization in recent initiatives for intervention and assessment in schizophrenia. Two of these initiatives are reviewed in this paper. The first focuses on the development and validation of the MATRICS Cognitive Consensus Battery, a standardized battery of neuropsychological tests developed to assess the effectiveness of cognitive enhancing treatments in schizophrenia. A part of this effort includes the identification of performance-based, ＇co-primary＇ measures of functional capacity that are related to cognition, and that are likely to show improvement at least partly as a function of improved cognition. The second initiative in- volves efforts to utilize neuropsychological deficits in the identification, validation and remediation of a liability syndrome for schizophrenia （＇schizotaxia＇）. The discussion of this effort focuses on the development of a syndrome that is both measurable and meaningful clinically, and that may provide useful intervention targets. The utilization of cognition in both of these initiatives underscores its functional importance in the clinical outcome of schizophrenia. Moreover, it helps to illuminate indicators of lia- bility for schizophrenia that might be amenable to remediation.
基金
supported in part by Ortho-McNeil Janssen Scientific Affairs, LLC
by National Institute of Mental Health Grant RO1-MH065562 (COGS
Consortium on the Genetics of Schizophrenia)
