Cognitive impairment in schizophrenia: aetiology, pathophysiology, and treatment

Cognitive deficits are a core feature of schizophrenia, account for much of the impaired functioning associated with the disorder and are not responsive to existing treatments. In this review, we first describe the clinical presentation and natural history of these deficits. We then consider aetiolo...

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Bibliographic Details
Published in:Molecular psychiatry 2023-05, Vol.28 (5), p.1902-1918
Main Authors: McCutcheon, Robert A., Keefe, Richard S. E., McGuire, Philip K.
Format: Article
Language:English
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Antipsychotics
Behavioral Sciences
Biological Psychology
Child development
Cognition
Cognition & reasoning
Cognition Disorders - etiology
Cognitive ability
Cognitive Dysfunction
Dopamine
Environmental factors
Etiology
Expert Review
Glutamatergic transmission
Humans
Interneurons
Medicine
Medicine & Public Health
Memory
Mental disorders
Neurosciences
Pathophysiology
Pharmacotherapy
Psychiatry
Psychosis
Psychotropic drugs
Pyramidal cells
Reviews
Schizophrenia
Standard deviation
γ-Aminobutyric acid
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Description
Summary:Cognitive deficits are a core feature of schizophrenia, account for much of the impaired functioning associated with the disorder and are not responsive to existing treatments. In this review, we first describe the clinical presentation and natural history of these deficits. We then consider aetiological factors, highlighting how a range of similar genetic and environmental factors are associated with both cognitive function and schizophrenia. We then review the pathophysiological mechanisms thought to underlie cognitive symptoms, including the role of dopamine, cholinergic signalling and the balance between GABAergic interneurons and glutamatergic pyramidal cells. Finally, we review the clinical management of cognitive impairments and candidate novel treatments.
ISSN:1359-4184
1476-5578
DOI:10.1038/s41380-023-01949-9