Cognitive issues are core symptoms of schizophrenia . More than 80 percent of people with schizophrenia have cognitive symptoms of some kind. They’re one of the main obstacles to managing schizophrenia, often causing substantial disability among those with the condition.e60dc2a1-f33c-4a05-9b50-8e3e8e597629545098cc-a558-4770-93f6-49900957b188 “These impairments often persist even during periods of symptom remission and can have a profound impact on daily functioning and quality of life,” says Caroline Fenkel , a doctor of social work, a licensed clinical social worker, and a cofounder and the chief clinical officer at Charlie Health, a virtual mental health care practice for young people that offers treatment for schizophrenia and related mental health conditions. If you or a loved one has been diagnosed with schizophrenia , here’s what to know about the causes of cognitive symptoms, their health effects, and how to manage them.
Types What Are the Cognitive Symptoms of Schizophrenia? The following cognitive symptoms are associated with schizophrenia. Memory Problems Cognitive symptoms relating to memory are extremely common, affecting as many as 98 percent of people with schizophrenia.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bb43a9d5-68da-4835-94c5-8b3bd21981ca “Memory issues can manifest as difficulties recalling recent events (short-term memory) or remembering information from the past (long-term memory),” says Joel Frank, PsyD , a clinical neuropsychologist in private practice in Los Angeles. “Everyday tasks such as remembering appointments, finding items, or following instructions can become challenging.” Attention Deficits Research shows that attention deficits are very common among people with schizophrenia.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bb43a9d5-68da-4835-94c5-8b3bd21981ca “These difficulties could involve struggles maintaining focus on tasks or conversations, being easily distracted, or having trouble shifting attention from one task to another,” says Dr. Frank. Impaired Social Cognition Social cognition refers to our ability to interpret social cues, understand the perspectives of others, and respond appropriately to social situations, says Frank. “Schizophrenia can affect this ability, leading to misinterpretations of others’ intentions or difficulties in managing social interactions,” he says. Impaired Executive Functioning “Executive functions refer to a set of cognitive processes that include problem-solving, planning, organizing, and decision-making,” says Frank. “Schizophrenia can impact these abilities, making it harder for individuals to plan their day, make decisions, or solve problems.” Language Difficulties Cognitive abilities that usually evolve throughout adult life, such as language, appear to deteriorate over time among people with schizophrenia.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292da3fb79-5bc5-4267-9c62-22443aff1b42 Some people with schizophrenia may speak very little, even when forced to interact with others. They may also speak in a monotonous tone or have trouble organizing their thoughts and words in a way that makes sense to others. This can sometimes result in jumbled speech. Concentration Issues “Concentrating for extended periods can be particularly challenging for people with schizophrenia,” Frank says. “They may find it hard to engage in activities that require sustained mental effort, such as reading, studying, or even watching a movie.”
Causes What Causes the Cognitive Symptoms of Schizophrenia? The causes of the cognitive symptoms of schizophrenia are multifaceted and not fully understood. “Several factors may contribute, including neurobiological factors, genetic factors, and environmental factors,” says Frank. Abnormal brain development may contribute to cognitive effects, according to research. This abnormal brain development seems to begin before birth, intensifies during childhood, and persists until adulthood. As a result, there are physical differences in the brain of a person diagnosed with schizophrenia compared with people without schizophrenia. Disruptions to genes linked to brain health and development — such as DISC1, NRG 1, and Akt1 — may play a role, too. Research also suggests that some antipsychotic medications used to treat schizophrenia, such as haloperidol (Haldol), can have side effects that may exacerbate cognitive symptoms further.
Health Effects How Can the Cognitive Symptoms of Schizophrenia Affect Your Health? Research has shown that cognitive impairment can have many health consequences for people with schizophrenia.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bb43a9d5-68da-4835-94c5-8b3bd21981ca “Adverse health outcomes can include difficulties in social and occupational functioning, decreased quality of life, poorer treatment adherence, and higher rates of unemployment and homelessness,” Dr. Fenkel says. Cognitive symptoms associated with schizophrenia can affect a person’s ability to manage their self-care and personal hygiene as well. They may also affect a person’s ability to comprehend and follow through with health-related instructions, and to be fully engaged in their treatment plan. These issues can make managing their overall mental and physical health much more challenging.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bb43a9d5-68da-4835-94c5-8b3bd21981ca
How to Manage How to Manage the Cognitive Symptoms of Schizophrenia Although medications like antipsychotics are the main treatment for managing most symptoms of schizophrenia ,e60dc2a1-f33c-4a05-9b50-8e3e8e597629b5dc0c0c-62a1-4dc7-86e5-a18fb6871f5f these medications often do little to improve cognitive functioning. And certain antipsychotics, like haloperidol, may actually worsen cognitive symptoms. Experts widely consider cognitive remediation therapy to be the best available option for managing the cognitive symptoms of schizophrenia. “Cognitive remediation therapy for schizophrenia is a structured treatment approach designed to target the cognitive deficits associated with schizophrenia,” says Frank. “It involves various exercises and activities aimed at improving memory, attention, problem-solving, and other cognitive functions.” The goal is to enhance overall cognitive abilities and improve daily functioning and quality of life for those with schizophrenia, Frank adds. Most cognitive remediation treatment programs involve approximately 24 hours of therapy administered by a trained health professional over three to six months.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294ffcd3b9-35f6-4b3f-853f-ffb6a5c40b12 If you need help finding a cognitive remediation program, try reaching out to your doctor, a local mental health center, or an organization such as the National Alliance on Mental Illness for recommendations. Unfortunately, there aren’t many professionals trained in this type of therapy, and it can be difficult to locate one. Some cognitive remediation software programs for use at home are available for purchase, but it’s not yet known how effective they are without involvement from a health professional.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294ffcd3b9-35f6-4b3f-853f-ffb6a5c40b12
The Takeaway Cognitive symptoms are common in schizophrenia and can include issues with memory, attention, language, and social functioning. Although medication is key to treating schizophrenia, it doesn’t help with cognitive symptoms. Cognitive remediation therapy is the best available treatment for the cognitive symptoms of schizophrenia.
Resources We Trust Mayo Clinic: SchizophreniaCleveland Clinic: SchizophreniaMolecular Psychiatry: Cognitive Impairment in Schizophrenia: Aetiology, Pathophysiology, and TreatmentClinical Psychopharmacology and Neuroscience: Cognitive Deficits in Schizophrenia: Understanding the Biological Correlates and Remediation StrategiesNational Institute of Mental Health: Schizophrenia
