Cognitive Functioning in Adults and Young People Diagnosed with Schizophrenia.

Summary
The Mental Health Foundation funded two research projects at the Institute of Psychiatry concerned with the difficulties that people diagnosed with schizophrenia experience with some cognitive tasks (thinking, memory, language). These projects aimed to increase understanding of the causes of cognitive difficulty and to evaluate ways of improving cognitive performance.

Study 1 used state-of-the-art functional magnetic resonance imaging (fMRI) scanning techniques to explore whether people diagnosed with schizophrenia and their close relatives (identical twins) show similarly unusual patterns of brain activity when carrying out language tasks.
Both people diagnosed with schizophrenia and their twin brothers/sisters showed unusual patterns of brain activity when performing verbal fluency tasks. This suggests that unusual brain activity during this task may be related to genetic vulnerability to schizophrenia, as opposed to schizophrenia per se.
People diagnosed with schizophrenia also had difficulty in identifying their own distorted speech, but their relatives who had no experience of psychosis did not show this difficulty. This task may, therefore be able to discriminate between people with a genetic risk and people who have actually experienced psychosis.
Study 2 was an evaluation of Cognitive Remediation Therapy (CRT), with young people diagnosed with schizophrenia at a relatively young age. CRT uses guided mental exercises to improve thinking, concentration and memory.
CRT was associated with significant additional improvements in the young peoples memory and flexibility of thinking.
CRT has the potential to improve the quality of life of young people recovering from an episode of psychosis. The researchers are continuing to analyze data from additional participants in order to increase the power of the study.

Background
People are usually diagnosed with schizophrenia because they have had psychotic experiences, such as hearing voices or holding bizarre beliefs. However, people with schizophrenia have also been found to differ from other people on measures of brain activity when performing certain cognitive tasks. For example, when asked to think of words beginning with a certain letter (the verbal fluency task) people diagnosed with schizophrenia tend to show unusual patterns of activation in the prefrontal cortex. Difficulties on cognitive tasks (attention, memory and problem solving) can affect recovery, by making it hard for someone to return to education or work. Although anti-psychotic drugs can be very helpful in controlling psychotic experiences such as delusions and hallucinations, they have little impact on problems of thinking and memory. Cognitive remediation therapy (CRT) has been used with adults to improve their cognitive performance, but hitherto it has not been evaluated with younger age groups.
The Research: STUDY 1
An MRI investigation of fronto-temporal network dysfunction in schizophrenia.

Vivienne Curtis, Robin Murray & Philip McGuire, of the Institute of Psychiatry, London, used MRI to examine whether people diagnosed with schizophrenia and their close relatives have difficulties in carrying out certain cognitive tasks, or show unusual brain activity when doing so. The aim was to learn more about how genetic and environmental factors influence brain function and the risk of psychotic experiences.
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