Evolution of schizophrenia: symptoms and prognoses

This clinical category refers to psychiatric alterations that change over time.

The evolution of schizophrenia can be studied by considering several aspects. For example, according to the manifestation, development and decrease of cognitive, behavioral or affective symptoms.

Likewise, 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 models of recovery in which the person is.

The following is a brief review of research that has analyzed the evolution of schizophrenia, specifically focusing on the symptoms of the cognitive dimension.

Evolution of schizophrenia and prognosis

The term "schizophrenia" refers to a psychiatric a psychiatric classification, and is generally defined as a chronic and severe disorder that affects the way people think, feel and act. that affects the way people think, feel and act. It is one of the least common but most representative mental disorders in psychiatry.

As the above definition explains, schizophrenia develops in both a behavioral dimension (the way of acting), an affective dimension (the way of feeling) and a cognitive one (thinking). The latter is, in fact, one of the most representative dimensions for diagnosis.

It is so because many people with the diagnosis of schizophrenia hear or see things that other people do not perceive. These things may be threatening, but not necessarily so.

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 develop his/her daily activities and interactions on a regular basis.

This depends to a large extent on the development and depends to a large extent on the individual's development and medical history, as well as the treatment options available to the individual.and the treatment options available to the person and his or her family. Therefore, 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 (i.e., conducted over time) on the evolution of cognitive symptoms in schizophrenia, Ojeda, et al. (2007) report that from the onset 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 impairment of neurodegenerative disorders.(2007) report that cognitive impairment increases gradually and especially in institutionalized patients, and no cases are reported that reach the degree of cognitive impairment of neurodegenerative disorders.

We will see some details about these studies, from the onset of the first psychotic episodes to long-standing schizophrenia.

1. In the first psychotic episodes

Studies carried out from the first psychotic episodes confirm the presence of a cognitive deficit starting from the first psychotic episodes. cognitive deficits from the early stages of development of schizophrenia..

However, the same studies suggest that, after performing attention, verbal fluency, psychomotor, 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 within the first twelve months.

Other studies conducted around the first 2 and 5 years of the disorder also report symptom stability. They also report stability in language and visual memory tasksand a notable improvement in other tasks, 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 explorations suggest that the course of cognitive manifestations show general stability in the early years, although a gradual deterioration towards the middle years. a gradual deterioration towards later periods..

2. In schizophrenia of long evolution

Early studies in long-standing or chronic schizophrenia, conducted since the 1960's, had reported a general stability of performance, with a slight deterioration in the language dimension. The latter was later debated, as it was not known whether such deterioration was caused by schizophrenia or 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 and, in others, deteriorations are reported. 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, there has been an increased interest in knowing the differentiation between the evolution of schizophrenia and other clinical conditions. It has also 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 related to the development of dementia. the development of dementia, especially in hospitalized geriatric patients.

Bibliographic references:

• National Institute of Mental Health (2015). Schizophrenia. Retrieved October 11, 2018. Available at https://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. Actas Españolas en Psiquiatría, 35(4): 253-270.