Esquizofrenia y Cognición
Comprensión de las Dimensiones Atencional, Perceptivas y Mnemotécnicas de la Esquizofrenia
DOI:
https://doi.org/10.34019/1982-1247.2020.v14.30284Resumen
La esquizofrenia es un trastorno mental grave e incapacitante cuyos criterios de diagnóstico son síntomas positivos, negativos, habla y pensamiento desorganizados o catatónicos. Se lleva a cabo con importantes disfunciones cognitivas con impactos en la atención, la función ejecutiva, el trabajo y la memoria de trabajo, entre otros. Tales déficits pueden estar presentes antes de los síntomas positivos o incluso, de manera subsindrómica desde la infancia de estos individuos. La hipótesis dopaminérgica es la más aceptada en la génesis de los trastornos neuroquímicos, pero cada vez hay más evidencia de la participación de otros sistemas como el glutamatérgico y el serotoninérgico. Con respecto específicamente a los déficits cognitivos, se destacan las disfunciones en la corteza prefrontal, especialmente su porción dorsolateral y sus conexiones con el hipocampo. También se entiende que la evaluación cognitiva de las personas afectadas por esta patología es muy importante y hay baterías de pruebas neuropsicológicas disponibles, como la Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) y pruebas validadas en Brasil como el Brief Assessment of Cognition in Schizophrenia (BACS). En vista de la alta pérdida de funcionalidad y calidad de vida de estos pacientes, especialmente los más afectados por la capacidad cognitiva, existe la necesidad de realizar mayores esfuerzos para comprender este complejo trastorno con miras a tratamientos más efectivos e incluso el desarrollo de estrategias preventivas.
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Amad, A., Cachia, A., Gorwood, P. et al. (2014). The multimodal connectivity of the hippocampal complex in
auditory and visual hallucinations. Mol Psychiatry 19, 184-191. https://doi.org/10.1038/mp.2012.181.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5 th ed.).
Arlington, VA: Author.
de Castro Ferreira Junior, B., do Amaral Barbosa, M., Barbosa, I. G., & Hara, C. (2010). Alterações cognitivas
na esquizofrenia: atualização Cognitive impairment in schizophrenia: an update. Rev Psiquiatr Rio Gd
Sul, 32(2), 57 – 63.
Cachia, A., Cury, C., Brunelin, J., Plaze, M., Delmaire, C., Oppenheim, C., Medjkane, F., Thomas, P., & Jardri,
R. (2020). Deviations in early hippocampus development contribute to visual hallucinations in
schizophrenia. Translational psychiatry, 10(1), 102. https://doi.org/10.1038/s41398-020-0779-9.
Cannon, M., Caspi, A., Moffit, T. E., Harrington, H., Taylor, A., Murray, R. M., & Poulton, R.(2002). Evidence
for early-childhood, pan-developmental impairment specific to schizophreniform disorder: results from
a longitudinal birth cohort. Archives of General Psychiatry,59 (5), 449-456.
Cao, H., Chén, O. Y., Chung, Y., Forsyth, J. K., McEwen, S. C., Gee, D. G., Bearden, C. E., Addington, J.,
Goodyear, B., Cadenhead, K. S., Mirzakhanian, H., Cornblatt, B. A., Carrión, R. E., Mathalon, D. H.,
McGlashan, T. H., Perkins, D. O., Belger, A., Seidman, L. J., Thermenos, H., Tsuang, M. T., … Cannon,
T. D. (2018). Cerebello-thalamo-cortical hyperconnectivity as a state-independent functional neural
signature for psychosis prediction and characterization. Nature communications, 9(1), 3836.
https://doi.org/10.1038/s41467-018-06350-7.
Clementz, BA, Sweeney, JA, Hamm, JP, Ivleva, EI, Ethridge, LE, Pearlson, GD, Keshavan, MS e Tamminga,
CA (2016). Identification of distinct psychosis biotypes using brain-based biomarkers. Am J
Psychiatry, 173 (4), 373-384. https://doi.org/10.1176/appi.ajp.2015.14091200.
Green, MF. (1996, march). What are the functional consequences of neurocognitive déficits in schizophrenia?
Am J Psychiatry, 153(3), 321 – 330.
Guo, J. Y., Ragland, J. D., & Carter, C. S. (2019). Memory and cognition in schizophrenia. Molecular
psychiatry, 24(5), 633–642. https://doi.org/10.1038/s41380-018-0231-1.
Kaneko K. (2018). Negative Symptoms and Cognitive Impairments in Schizophrenia: Two Key Symptoms
Negatively Influencing Social Functioning. Yonago acta medica, 61 (2), 91
102. https://doi.org/10.33160/yam.2018.06.001.
Kaplan, H. I., Sadock, B. J., & Grebb, J. A. (2007). Compêndio de psiquiatria: ciências do comportamento e
psiquiatria clínica. (9th ed.). Porto Alegre: Artmed.
Keefe R.S.E., Harvey P.D. (2012) Cognitive Impairment in Schizophrenia. In: Geyer M., Gross G. (eds) Novel
Antischizophrenia Treatments. Handbook of Experimental Pharmacology, vol 213. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-25758-2_2.
Keefe, R. S., Poe, M., Walker, T. M., Kang, J. W., & Harvey, P. D. (2006, march). The Schizophrenia Cognition
Rating Scale: An Interview-Based Assessment and Its Relationship to Cognition, Real-World
Functioning, and Functional Capacity. The American Journal of Psychiatry, 163(3), 426 – 432.
Retrieved from https://doi.org/10.1176/appi.ajp.163.3.426.
Kesby, J. P., Eyles, D. W., McGrath, J. J., & Scott, J. G. (2018). Dopamine, psychosis and schizophrenia: the
widening gap between basic and clinical neuroscience. Translational psychiatry, 8(1), 30. https://doi.org/10.1038/s41398-017-0071-9.
Kirchhoff, B. A., Anderson, B. A., Smith, S. E., Barch, D. M., & Jacoby, L. L. (2012). Cognitive training
related changes in hippocampal activity associated with recollection in older adults. NeuroImage, 62(3), 1956–1964. https://doi.org/10.1016/j.neuroimage.2012.06.017.
Kucwaj, H., & Chuderskia, A. (2020, june). Susceptibility to distraction during analogical reasoning in
schizophrenia. Schizophrenia Research: Cognition, 20. Disponível em
https://doi.org/10.1016/j.scog.2019.100170.
Lau, C., Wang, H., Hsu, J., & Liu, M. (2013). Does the dopamine hypothesis explain schizophrenia?, Reviews
in the Neurosciences, 24(4), 389-400. doi: https://doi.org/10.1515/revneuro-2013-0011.
Lima, T., Silva, J., & Batista, E. (2017). Perfil epidemiológico de pacientes com esquizofrenia em uso de antipsicóticos de ação prolongada. Revista Contexto & Saúde, 17(33), 3-16. https://doi.org/10.21527/2176-7114.2017.33.3-16.
Monteiro, Luciana de Carvalho, & Louzã, Mário Rodrigues. (2007). Alterações cognitivas na esquizofrenia:
conseqüências funcionais e abordagens terapêuticas. Archives of Clinical Psychiatry (São Paulo), 34(Suppl. 2), 179-183. https://doi.org/10.1590/S0101-60832007000800006.
Nuechterlein, K. H., GreenB, M. F., Kern, R. S., Baade, L. E., Barch, D. M., Cohen, J. D., . . . Kraemer, H.
(2008). The MATRICS Consensus Cognitive Battery, Part 1: Test Selection, Reliability, and Validity. Am J Psychiatry, 165, 203 – 213.
Orellana, G., & Slachevsky, A. (2013). Executive functioning in schizophrenia. Frontiers in psychiatry, 4, 35.
https://doi.org/10.3389/fpsyt.2013.00035.
Organização Mundial da Saúde / Organização Pan-Americana de Saúde. (2018). Perguntas e respostas: revisão
da Classificação Internacional de Doenças (CID). Disponível em https://www.paho.org/bra/index.php?option=comcontentview = articleid = 5574: perguntas−e−respostas−revisao−da−classificacao−internacional−de−doencas−cidItemid = 875.
PAULINO, M. C. (2013). Perfil sociodemográfico e caracterização do tratamento psicofarmacológico oferecido
aos sujeitos com esquizofrenia atendidos pelo centro de atenção psicossocial saúde mental no município de Itajaí (SC). (Graduação em Farmácia). Universidade do Vale do Itajaí.
Pek TM, Yazici E, D Guzel D, Kose E, Yazıcı AB & Erol A (2019) The relationship between oxytocin,
vasopressin and atrial natriuretic peptide levels and cognitive functions in patients with
schizophrenia. Psychiatry and Clinical Psychopharmacology, 29:4, 798
810, DOI: 10.1080/24750573.2019.1653149.
Salgado, J. V., Carvalhaes, C., Pires, A. M., Neves, M., Cruz, B. F., Cardoso, C. S., Lauar, H., Teixeira, A. L.,
& Keefe, R. (2007). Sensitivity and applicability of the Brazilian version of the Brief Assessment of
Cognition in Schizophrenia (BACS). Dementia & neuropsychologia, 1(3), 260–265.
https://doi.org/10.1590/S1980-57642008DN10300007.
Sheffield, JM & Barch, DM (2016). Cognition and resting-state functional connectivity in
schizophrenia. Neurocience & Biobehavioral Reviews, 61, 108
120. https://doi.org/10.1016/j.neubiorev.2015.12.007.
Stępnicki, P., Kondej, M., & Kaczor, AA (2018). Current concepts and treatments of schizophrenia. Molecules
(Basel, Suíça), 23 (8), 2087. https://doi.org/10.3390/molecules23082087.
Teigset, C. M., Mohn, C., & Rund, B. R. (2020). Perinatal complications and executive dysfunction in early
onset schizophrenia. BMC Psychiatry, 20(103). httphttps://doi.org/10.1186/s12888-020-02517-zs://doi.org/10.1186/s12888-020-0251.
Vasconcellos, P. C. (2014). A relação entre sintomas negativos e cognição social na esquizofrenia
(Especialização em Neurociências do Instituto de Ciências Biológicas, UNIVERSIDADE FEDERAL
DE MINAS GERAIS). Disponível em https://repositorio.ufmg.br/bitstream/1843/VRNS-9TDNTY/1/monografia.pdf.
auditory and visual hallucinations. Mol Psychiatry 19, 184-191. https://doi.org/10.1038/mp.2012.181.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5 th ed.).
Arlington, VA: Author.
de Castro Ferreira Junior, B., do Amaral Barbosa, M., Barbosa, I. G., & Hara, C. (2010). Alterações cognitivas
na esquizofrenia: atualização Cognitive impairment in schizophrenia: an update. Rev Psiquiatr Rio Gd
Sul, 32(2), 57 – 63.
Cachia, A., Cury, C., Brunelin, J., Plaze, M., Delmaire, C., Oppenheim, C., Medjkane, F., Thomas, P., & Jardri,
R. (2020). Deviations in early hippocampus development contribute to visual hallucinations in
schizophrenia. Translational psychiatry, 10(1), 102. https://doi.org/10.1038/s41398-020-0779-9.
Cannon, M., Caspi, A., Moffit, T. E., Harrington, H., Taylor, A., Murray, R. M., & Poulton, R.(2002). Evidence
for early-childhood, pan-developmental impairment specific to schizophreniform disorder: results from
a longitudinal birth cohort. Archives of General Psychiatry,59 (5), 449-456.
Cao, H., Chén, O. Y., Chung, Y., Forsyth, J. K., McEwen, S. C., Gee, D. G., Bearden, C. E., Addington, J.,
Goodyear, B., Cadenhead, K. S., Mirzakhanian, H., Cornblatt, B. A., Carrión, R. E., Mathalon, D. H.,
McGlashan, T. H., Perkins, D. O., Belger, A., Seidman, L. J., Thermenos, H., Tsuang, M. T., … Cannon,
T. D. (2018). Cerebello-thalamo-cortical hyperconnectivity as a state-independent functional neural
signature for psychosis prediction and characterization. Nature communications, 9(1), 3836.
https://doi.org/10.1038/s41467-018-06350-7.
Clementz, BA, Sweeney, JA, Hamm, JP, Ivleva, EI, Ethridge, LE, Pearlson, GD, Keshavan, MS e Tamminga,
CA (2016). Identification of distinct psychosis biotypes using brain-based biomarkers. Am J
Psychiatry, 173 (4), 373-384. https://doi.org/10.1176/appi.ajp.2015.14091200.
Green, MF. (1996, march). What are the functional consequences of neurocognitive déficits in schizophrenia?
Am J Psychiatry, 153(3), 321 – 330.
Guo, J. Y., Ragland, J. D., & Carter, C. S. (2019). Memory and cognition in schizophrenia. Molecular
psychiatry, 24(5), 633–642. https://doi.org/10.1038/s41380-018-0231-1.
Kaneko K. (2018). Negative Symptoms and Cognitive Impairments in Schizophrenia: Two Key Symptoms
Negatively Influencing Social Functioning. Yonago acta medica, 61 (2), 91
102. https://doi.org/10.33160/yam.2018.06.001.
Kaplan, H. I., Sadock, B. J., & Grebb, J. A. (2007). Compêndio de psiquiatria: ciências do comportamento e
psiquiatria clínica. (9th ed.). Porto Alegre: Artmed.
Keefe R.S.E., Harvey P.D. (2012) Cognitive Impairment in Schizophrenia. In: Geyer M., Gross G. (eds) Novel
Antischizophrenia Treatments. Handbook of Experimental Pharmacology, vol 213. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-25758-2_2.
Keefe, R. S., Poe, M., Walker, T. M., Kang, J. W., & Harvey, P. D. (2006, march). The Schizophrenia Cognition
Rating Scale: An Interview-Based Assessment and Its Relationship to Cognition, Real-World
Functioning, and Functional Capacity. The American Journal of Psychiatry, 163(3), 426 – 432.
Retrieved from https://doi.org/10.1176/appi.ajp.163.3.426.
Kesby, J. P., Eyles, D. W., McGrath, J. J., & Scott, J. G. (2018). Dopamine, psychosis and schizophrenia: the
widening gap between basic and clinical neuroscience. Translational psychiatry, 8(1), 30. https://doi.org/10.1038/s41398-017-0071-9.
Kirchhoff, B. A., Anderson, B. A., Smith, S. E., Barch, D. M., & Jacoby, L. L. (2012). Cognitive training
related changes in hippocampal activity associated with recollection in older adults. NeuroImage, 62(3), 1956–1964. https://doi.org/10.1016/j.neuroimage.2012.06.017.
Kucwaj, H., & Chuderskia, A. (2020, june). Susceptibility to distraction during analogical reasoning in
schizophrenia. Schizophrenia Research: Cognition, 20. Disponível em
https://doi.org/10.1016/j.scog.2019.100170.
Lau, C., Wang, H., Hsu, J., & Liu, M. (2013). Does the dopamine hypothesis explain schizophrenia?, Reviews
in the Neurosciences, 24(4), 389-400. doi: https://doi.org/10.1515/revneuro-2013-0011.
Lima, T., Silva, J., & Batista, E. (2017). Perfil epidemiológico de pacientes com esquizofrenia em uso de antipsicóticos de ação prolongada. Revista Contexto & Saúde, 17(33), 3-16. https://doi.org/10.21527/2176-7114.2017.33.3-16.
Monteiro, Luciana de Carvalho, & Louzã, Mário Rodrigues. (2007). Alterações cognitivas na esquizofrenia:
conseqüências funcionais e abordagens terapêuticas. Archives of Clinical Psychiatry (São Paulo), 34(Suppl. 2), 179-183. https://doi.org/10.1590/S0101-60832007000800006.
Nuechterlein, K. H., GreenB, M. F., Kern, R. S., Baade, L. E., Barch, D. M., Cohen, J. D., . . . Kraemer, H.
(2008). The MATRICS Consensus Cognitive Battery, Part 1: Test Selection, Reliability, and Validity. Am J Psychiatry, 165, 203 – 213.
Orellana, G., & Slachevsky, A. (2013). Executive functioning in schizophrenia. Frontiers in psychiatry, 4, 35.
https://doi.org/10.3389/fpsyt.2013.00035.
Organização Mundial da Saúde / Organização Pan-Americana de Saúde. (2018). Perguntas e respostas: revisão
da Classificação Internacional de Doenças (CID). Disponível em https://www.paho.org/bra/index.php?option=comcontentview = articleid = 5574: perguntas−e−respostas−revisao−da−classificacao−internacional−de−doencas−cidItemid = 875.
PAULINO, M. C. (2013). Perfil sociodemográfico e caracterização do tratamento psicofarmacológico oferecido
aos sujeitos com esquizofrenia atendidos pelo centro de atenção psicossocial saúde mental no município de Itajaí (SC). (Graduação em Farmácia). Universidade do Vale do Itajaí.
Pek TM, Yazici E, D Guzel D, Kose E, Yazıcı AB & Erol A (2019) The relationship between oxytocin,
vasopressin and atrial natriuretic peptide levels and cognitive functions in patients with
schizophrenia. Psychiatry and Clinical Psychopharmacology, 29:4, 798
810, DOI: 10.1080/24750573.2019.1653149.
Salgado, J. V., Carvalhaes, C., Pires, A. M., Neves, M., Cruz, B. F., Cardoso, C. S., Lauar, H., Teixeira, A. L.,
& Keefe, R. (2007). Sensitivity and applicability of the Brazilian version of the Brief Assessment of
Cognition in Schizophrenia (BACS). Dementia & neuropsychologia, 1(3), 260–265.
https://doi.org/10.1590/S1980-57642008DN10300007.
Sheffield, JM & Barch, DM (2016). Cognition and resting-state functional connectivity in
schizophrenia. Neurocience & Biobehavioral Reviews, 61, 108
120. https://doi.org/10.1016/j.neubiorev.2015.12.007.
Stępnicki, P., Kondej, M., & Kaczor, AA (2018). Current concepts and treatments of schizophrenia. Molecules
(Basel, Suíça), 23 (8), 2087. https://doi.org/10.3390/molecules23082087.
Teigset, C. M., Mohn, C., & Rund, B. R. (2020). Perinatal complications and executive dysfunction in early
onset schizophrenia. BMC Psychiatry, 20(103). httphttps://doi.org/10.1186/s12888-020-02517-zs://doi.org/10.1186/s12888-020-0251.
Vasconcellos, P. C. (2014). A relação entre sintomas negativos e cognição social na esquizofrenia
(Especialização em Neurociências do Instituto de Ciências Biológicas, UNIVERSIDADE FEDERAL
DE MINAS GERAIS). Disponível em https://repositorio.ufmg.br/bitstream/1843/VRNS-9TDNTY/1/monografia.pdf.
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Publicado
2020-10-24
Número
Sección
Número Temático Cérebro & Mente: Reflexões e Processos Psicológicos Básicos
