Evolution of schizophrenia: symptoms and prognosis

The evolution of schizophrenia can be studied considering different aspects. For example, depending on the manifestation, development, and decrease of cognitive, behavioral, or affective symptoms.

Likewise, and as occurs with other psychiatric and medical diagnoses, the evolution of these manifestations depends on many variables. Some of them are psychological and biological susceptibility, and also the conditions or models of recovery in which the person finds himself.

Below we will briefly review research that has analyzed the evolution of schizophrenia, specifically focusing on the symptoms of the cognitive dimension.

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Evolution of schizophrenia and prognosis

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

As the previous definition explains it, schizophrenia develops both in a behavioral dimension (the way of acting), and in an affective one (the way of feeling).

and other cognitive (in thought). The latter is, in fact, one of the most representative dimensions for diagnosis.

This is so because many of the people diagnosed with 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 type manifestations can be an obstacle for the person to develop their daily activities and interactions in a way regular.

The above highly dependent on development and individual medical historyas well as the treatment options that the person and their family have access to. For this reason, one of the most relevant issues for the scientific community has been the study of the evolution of these manifestations and the variables involved in it.

• You may be interested in: "What is psychosis? Causes, symptoms and treatment"

How do cognitive manifestations develop?

In a review of 30 longitudinal (ie, conducted over time) studies on the evolution of cognitive symptoms in schizophrenia, Ojeda, et al. (2007) report that from the beginning cognition is significantly altered.

They also report that the disturbance 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 appearance 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 from the early stages of development of schizophrenia.

However, the same studies suggest that, after performing attention tasks, verbal fluency, psychomotor skills, and visual and verbal memory; said deficit tends to improve significantly in the first year. The latter has been associated with stabilization of positive symptoms over the course of 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 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 presents general stability in the early years, although a gradual deterioration towards the later periods.

2. In longstanding schizophrenia

The first studies on long-standing or chronic schizophrenia, carried out since the 1960s, had reported a general stability of 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 caused by schizophrenia or 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 important improvements are reported and, in others, deterioration. In the latter, one of the important variables has been institutionalization, since many of the people were in long-term hospitalization.

In fact, from the latter, interest in knowing the differentiation between the evolution of schizophrenia and other clinical pictures has increased. Likewise, the scientific analysis of the variables involved in the stability, improvement or deterioration of cognitive functions in people diagnosed with schizophrenia has increased. Schizophrenia has recently 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 in 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. Spanish Acts in Psychiatry, 35(4): 253-270.