Evolution Of Schizophrenia: Symptoms And Prognoses
The evolution of schizophrenia can be studied considering different aspects For example, according to the manifestation, development and reduction of cognitive, behavioral or affective symptoms.
Likewise, and as occurs with other psychiatric and medical diagnoses, the evolution of these manifestations depends on many variables. Some of them are psychological and biological susceptibility, and also the conditions or recovery models in which the person finds themselves.
Below we will briefly review research that has analyzed the evolution of schizophrenia, specifically focusing on the symptoms of the cognitive dimension.
The term “schizophrenia” refers to a psychiatric classification, and is generally defined as a chronic and severe disorder It affects the way people think, feel and act. It is one of the least common mental disorders, although most representative of psychiatry.
As the previous definition explains, schizophrenia develops both in a behavioral dimension (the way of acting) and in an affective dimension (the way of feeling). and another cognitive (in thought). The latter is, in fact, one of the most representative dimensions for diagnosis.
This is because many people diagnosed with schizophrenia hear or see things that other people do not perceive. These things can be threatening, but not necessarily.
Depending on how they are presented and how they are received by other people, the development and evolution of cognitive manifestations can be an obstacle for the person to carry out their daily activities and interactions on a regular basis.
The above largely depends on individual development and clinical history, as well as the treatment options to which the person and their family have access. For this reason, one of the most relevant topics for the scientific community has been the study of the evolution of these manifestations and the variables involved in this.
How do cognitive manifestations develop?
In a review of 30 longitudinal studies (that is, conducted over time) on the evolution of cognitive symptoms in schizophrenia, Ojeda, et al. (2007) report that from the beginning cognition is significantly altered.
They also report that The alteration increases gradually and especially in institutionalized patients and no cases are reported that reach the degree of cognitive alteration of neurodegenerative disorders.
We will see some details about these studies, from the appearance of the first psychotic episodes to long-term schizophrenia.
1. In the first psychotic episodes
Studies carried out since the first psychotic episodes confirm the presence of a cognitive deficit from the early stages of development of schizophrenia
However, the same studies suggest that, after performing attention, verbal fluency, psychomotor, and visual and verbal memory tasks; This deficit tends to improve significantly in the first year. The latter has been associated with the stabilization of positive symptoms over the course of the first twelve months.
In other studies carried out during the first 2 and 5 years of the disorder, the stability of the symptoms is also reported. They also report stability in language and visual memory tasks and a notable improvement in others, such as conceptual tasks, and attention/concentration.
However, other studies that have also followed up the first two years report little improvement, or even slight deterioration in visuospatial reasoning and processing speed. On the other hand, longer examinations suggest that the course of cognitive manifestations shows general stability in the first years, although a gradual deterioration towards later periods
2. In long-term schizophrenia
The first studies in long-term or chronic schizophrenia, carried out since the 60’s, had reported a general stability of performance, with a slight deterioration in the language dimension. The latter was later debated, since it was not known whether this deterioration was the cause of schizophrenia or was caused by the natural aging process.
In general, subsequent studies confirm the stability of cognitive symptoms in the evolution of schizophrenia, although in some cases significant improvements are reported and, in others, deteriorations. In the latter, one of the important variables has been institutionalization, since many of the people were in long-stay hospitalization
In fact, since the latter, interest has increased in knowing the differentiation between the evolution of schizophrenia and other clinical conditions. Likewise, scientific analysis of the variables involved in the stability, improvement or deterioration of cognitive functions in people diagnosed with schizophrenia has increased. Schizophrenia has recently been linked to the development of dementia especially in hospitalized geriatric patients.
