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 symptomatology.
Likewise, and as with other psychiatric and medical diagnoses, the evolution of these manifestations depends on many variables. Some of them are the psychological and biological susceptibility, and also the conditions or recovery models in which the person is.
Next we will make a brief review of research that has analyzed the evolution of schizophrenia, specifically focusing on the symptoms of the cognitive dimension.
- Related article: "What is schizophrenia? Symptoms and treatments"
Evolution of schizophrenia and prognosis
The term "schizophrenia" refers to a psychiatric classification, and is generally defined as a chronic and serious disorder that affects the way people think, feel and act. It is one of the less frequent mental disorders, although more representative of psychiatry.
As the previous definition explains, schizophrenia develops both in a behavioral dimension (the way of acting), as in an affective one (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 of the people with the diagnosis of 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-type manifestations can be an obstacle for the person to develop their activities and daily interactions on a regular basis.
The above depends largely on the development and individual 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.
- You may be interested: "What is psychosis? Causes, symptoms and treatment"
How do cognitive manifestations develop?
In a review of 30 longitudinal studies (ie, a realizer over time) on the evolution of cognitive symptoms in schizophrenia, Ojeda, et al. (2007) report that cognition is significantly altered from the beginning.
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-standing schizophrenia.
1. In the first psychotic episodes
Studies conducted 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 tasks, verbal fluency, psychomotricity and visual and verbal memory; This deficit tends to improve significantly in the first year. The latter has been associated with the stabilization of positive symptoms during the first twelve months.
In other studies carried out towards the first 2 and 5 years of the disorder, the stability of the symptoms is also reported. They also report stability in language tasks and visual memory , and a notable improvement in others, such as conceptual tasks, and attention / concentration.
However, other studies that have also followed the first two years report little improvement, or even slight deterioration in visuospatial reasoning and processing speed. On the other hand, longer explorations suggest that the course of cognitive manifestations presents general stability in the first years, although a gradual deterioration towards later periods .
2. In long-standing schizophrenia
The first studies in schizophrenia of long evolution or chronicle, realized from the 60's, had reported a general stability of the performance, with a slight deterioration in the dimension of the language. 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, impairments. In the latter, one of the important variables has been institutionalization, since many of the people were in long stay hospitalization .
In fact, from this last point the interest to know the differentiation between the evolution of schizophrenia and other clinical pictures has increased. Likewise, it has increased the scientific analysis of the variables involved in the stability, improvement or deterioration of cognitive functions in people diagnosed with schizophrenia. Recently schizophrenia has been linked to the development of dementia , especially in hospitalized geriatric patients.
Bibliographic references:
- National Institute of Mental Health (2015). Schizophrenia. Retrieved October 11, 2018. Available at //www.nimh.nih.gov/health/publications/espanol/la-esquizofrenia/index.shtml.
- Ojeda, N., Sánchez, P., Elizagárate, E., Yöller, A.B., Ezcurra, J., Ramírez, I. and Ballesteros, J. (2007). Evolution of cognitive symptoms in schizophrenia: a review of the literature. Spanish Acts in Psychiatry, 35 (4): 253-270.
