The need to develop personalized interventions to improve cognition in schizophrenia

Abstract

World Psychiatry 18:2 June 2019 in treatment development and efficacy research, such as the evaluation of the neuropeptide oxytocin, which has shown some effects on social cognition in schizophrenia. Interventions such as oxytocin or modafinil, used in combination with gamified cognitive training, may synergize to increase plasticity and learning, promoting improvement in both “hot” and “cold” cognition as well as in social functioning. Augmentation therapies would be particularly useful for rehabilitating patients who have cognitive impairments that persist even after remission of the more acute symptoms. If young people with schizophrenia are to have the best chance of realizing their potential and of having good functionality and wellbeing, we will have to move to game-changing initiatives that prioritize early detection and early effective intervention. With a move to first-episode psychosis clinics and research studies focusing on children and adolescents with an ultra-high risk of schizophrenia, interventions that target cognition and motivation can be implemented much earlier in the course of the illness, before “rescuing” cognition is the only option. Good cognition and positive wellbeing are closely linked and both are required for a flourishing society.