Treatment of cognition and affect in schizophrenia

Abstract

Background and Aims

An increasing number of treatment studies focus on impaired cognition and emotion processing in schizophrenia. In study 1 we evaluated neuronal activation with fMRI during facial emotion processing in schizophrenia patients treated with new antipsychotics. The study 2 was carried out in order to evaluate whether combinations of new antipsychotics with a cognitive training (Cogpack) or a Training of Affect Decoding (TAD) were more effective than new antipsychotics alone.

Methods

In the first study patients with schizophrenia (n=11) and matched healthy controls (n=11) viewed facial displays of emotions. FMRI was used to measure BOLD signal changes as patients alternated beween tasks requiring discrimination of emotional valence of faces and age. In the second study schizophrenic patients (n=20) were compared with a randomized group of patients in the Cogpack (N=20) and in the TAD (n=20).

Results

The same activation patterns in the amygdala were apparent in schizophrenic patients treated with new antipsychotics and healthy controls. The cognition training group revealed significant improvements in cognitive functions and transfer effects in skills needed for daily life. In the TAD group significant improvements were found in recognition of sad facial emotions.

Conclusions

New antipsychotics may improve the functionality of the networks needed for emotion processing and cognition. Cogpack training and TAD, in combination with new antipsychotics, are important treatment techniques for improving social functioning relevant for rehabilitation.