bekhterevОбозрение психиатрии и медицинской психологии имени В.М.БехтереваV.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY2313-70532713-055XV. M. BEKHTEREV NATIONAL RESEARCH MEDICAL CENTER FOR PSYCHIATRY AND NEUROLOGY OF THE RUSSIAN FEDERATION MINISTRY OF HEALTH10.31363/2313-7053-2019-3-3-9bekhterev-266Research ArticleПРОБЛЕМНЫЕ СТАТЬИPROBLEM-S0LVING ARTICLESСовременная дилемма терапии шизофрении: нейрокогниции и социальные когницииModern dilemma in the therapy of the schizophrenia: neurocognition and social cognitionЛутоваН. Б.LutovaN. B.

Наталия Борисовна Лутова — гл.н.с., д.м.н., руководитель отделения интегративной фармако-психотерапии больных с психическими расстройствами

lutova@mail.ruВидВ. Д.WiedV. D.

Виктор Давыдович Вид — д.м.н., профессор, главный научный сотрудник отделения интегративной фармако-психотерапии больных с психическими расстройствами

wied@mail.ruНациональный медицинский исследовательский центр психиатрии и неврологии им. В.М.БехтереваРоссияV.M. Bekhterev national research medical center for psychiatry and neurologyRussian Federation2019061020190339Copyright © Лутова Н.Б., Вид В.Д., 20192019Лутова Н.Б., Вид В.Д.Lutova N.B., Wied V.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bekhterevreview.com/jour/article/view/266

Новейшие данные исследований свидетельствуют о том, что успехи психофармакотерапии шизофрении в преодолении продуктивной психотической симптоматики не сопровождаются существенным снижением частоты рецидивирования и улучшением социального функционирования. Главной причиной этого является резистентность когнитивного дефицита больных к действию антипсихотиков. Обсуждается значение дифференцировки когнитивного дефицита на нарушения нейрокогниций и социальных когниций для дальнейшей оптимизации общей стратегии лечения шизофрении.

Recent research data make it evident that the last generations of antypsychotics being successful in elimination of the positive psychotic symptoms still seem to be incapable to sufficiently lower exacerbation frequency and to improve social functioning. The primary reason for that is considered to be an insufficient response of the patients’ cognitive deficit to the action of antipsychotics. The importance to differentiate between neurocognition and social cognition in view of the schizophrenia treatment general strategy optimization is discussed.

шизофрениякогнитивный дефицитнейрокогницииschizophreniacognitive deficitneurocognitionReferencesДорофейкова М.В. Когнитивные нарушения и клинико-лабораторные характеристики у больных шизофренией// Обозрение психиатрии и медицинской психологии им. В.М. Бехтерева — 2017. –№1. — С.38-43.Dorofeykova M.V. Changes in levels of neuromarkers and cognitive functioning of patients with treatmentresistant schizophrenia. Obozrenie psikhiatrii i meditsinkoi psikhologii im. V.M. Bekhtereva. 2016; 3:38-43. (In Rus.).Янушко М.Г., Иванов М.В., Сорокина А.В. Когнитивные нарушения при эндогенных психозах: представления в свете дименсионального подхода// Социальная и клиническая психиатрия. — 2104. — Т.24. — С.90-95.Yanushko M.G., Ivanov M.V., Sorokina A.V. Cognitive disorders in endogenous psychoses: contemporaryperspective in the light of dimensional approach. Sotsial’naya I klinicheskaya psikhiatriya. 2014; 24:90-95. (In Rus.).Bellack A.S., Morrison R.L., Wixted J.T., Mueser K.T. An analysis of social competence in schizophrenia//Brit. J. Psychiatry. — 1990. — Vol.156. — P.809-818. DOI: 10.1192/bpj.156.6.809Bellack A.S., Morrison R.L., Wixted J.T., Mueser K.T. An analysis of social competence in schizophrenia//Brit. J. Psychiatry. — 1990. — Vol.156. — P.809-818. DOI: 10.1192/bpj.156.6.809Brekke J., Kay D.D., et al. Biosocial pathways to social outcome in schizophrenia: a path analytic model. — Schizophr. Res. — 2005. — Vol. 80, — P.213-225. DOI: 10.1016/j.schres.2005.07.008Brekke J., Kay D.D., et al. Biosocial pathways to social outcome in schizophrenia: a path analytic model. — Schizophr. Res. — 2005. — Vol. 80, — P.213-225. DOI: 10.1016/j.schres.2005.07.008Chan J.Y.H., Ng S.S,W., Lo A.W.Y., et al. Correlation of neurocognition with social cognition in people with schizophrenia. — Int. J. Psychol. Behav. Anal. — 2018. — №4. — P.139. DOI: 10.15344/2018/2455-3867/139Chan J.Y.H., Ng S.S,W., Lo A.W.Y., et al. Correlation of neurocognition with social cognition in people with schizophrenia. — Int. J. Psychol. Behav. Anal. — 2018. — №4. — P.139. DOI: 10.15344/2018/2455-3867/139Corrigan P., Toomey R. Interpersonal problem solving and information processing deficits in schizophrenia. — Schizophr. Bull. — 1995. — Vol.21 — P.395-403.Corrigan P., Toomey R. Interpersonal problem solving and information processing deficits in schizophrenia. — Schizophr. Bull. — 1995. — Vol.21 — P.395-403.Deckler E. et al. Social cognition and neurocognition in schizophrenia and healthy controls: intercorrelation of performance and effects of manipulations aimed at increasing task difficulty. — Front. Psychiatry. — 2018. — Vol.7. DOI: 10.3389/fpsyt.2018.00356.Deckler E. et al. Social cognition and neurocognition in schizophrenia and healthy controls: intercorrelation of performance and effects of manipulations aimed at increasing task difficulty. — Front. Psychiatry. — 2018. — Vol.7. DOI: 10.3389/fpsyt.2018.00356.Fett A.K., Viechtbauer W., Dominquez M.P., et al. The ralationship between neurogognition and social cognition with functional outcomes in schizophrenia: a meta-analysis. — Neurosci. — Biobehav. Rev. — 2011. –Vol.35. — P.573-588. DOI: 10.1016/j.neubiorev. 2010.07.001.Fett A.K., Viechtbauer W., Dominquez M.P., et al. The ralationship between neurogognition and social cognition with functional outcomes in schizophrenia: a meta-analysis. — Neurosci. — Biobehav. Rev. — 2011. –Vol.35. — P.573-588. DOI: 10.1016/j.neubiorev. 2010.07.001.Green M., Nuechterlein K. The MATRICS Initiative: Developing a consensus cognitive battery for clinical trials. — Schizophr. Res. — 2004. – Vol.72. –P.1-3. DOI: 10.1016/j.schres.2004.09.006Green M., Nuechterlein K. The MATRICS Initiative: Developing a consensus cognitive battery for clinical trials. — Schizophr. Res. — 2004. – Vol.72. –P.1-3. DOI: 10.1016/j.schres.2004.09.006Haefner H., Riecher-Rossler A., Hambrecht M.,et al. IRAOS — an instrument for the assessment of the onset and early course of schizophrenia. — Schizophr. Res. –1992. — Vol.6. — P.209-223. DOI:10.1016/0920-9964(92)90004-OHaefner H., Riecher-Rossler A., Hambrecht M.,et al. IRAOS — an instrument for the assessment of the onset and early course of schizophrenia. — Schizophr. Res. –1992. — Vol.6. — P.209-223. DOI:10.1016/0920-9964(92)90004-OHeinrichs R.W., Zakzanis K.K. Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. — Neuropsychology. — 1998. –№12. — P.426-445. DOI: 10.1037/0894-4105.12.3.126Heinrichs R.W., Zakzanis K.K. Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. — Neuropsychology. — 1998. –№12. — P.426-445. DOI: 10.1037/0894-4105.12.3.126Hoe M., Nakagami E., Green M.F., et al. The causal relationships between neurocognition, social cognition and functional outcome over time in schizophrenia: a latent difference score approach. — Psychol. Med.– 2012. DOI:10.1017/S0033291712000578.Hoe M., Nakagami E., Green M.F., et al. The causal relationships between neurocognition, social cognition and functional outcome over time in schizophrenia: a latent difference score approach. — Psychol. Med.– 2012. DOI:10.1017/S0033291712000578.Jain M., Singh S., Dalal R.K. et al. A crosssectional study of cognitive functions and disability in schizophrenia from a tertiary care hospital in North India. — Med. J. DY Patil Univ. — 2016. — №9. — P.457-464. DOI:10.4103/0975-2870.186056Jain M., Singh S., Dalal R.K. et al. A crosssectional study of cognitive functions and disability in schizophrenia from a tertiary care hospital in North India. — Med. J. DY Patil Univ. — 2016. — №9. — P.457-464. DOI:10.4103/0975-2870.186056Jaramillo P., Fuentes I., Ruiz I., Ruiz J.C. Cognition, social cognition and social functioning in schizophrenia. Psychology, Society & Education. — 2009. — Vol.1. — P.13-24.Jaramillo P., Fuentes I., Ruiz I., Ruiz J.C. Cognition, social cognition and social functioning in schizophrenia. Psychology, Society & Education. — 2009. — Vol.1. — P.13-24.Kaneko K. Negative symptoms and cognitive impairments in schizophrenia: two key symptoms negatively influencing social functioning. Yonago Acta Med. — 2018. — Vol. 61(2). — P.91-102.Kaneko K. Negative symptoms and cognitive impairments in schizophrenia: two key symptoms negatively influencing social functioning. Yonago Acta Med. — 2018. — Vol. 61(2). — P.91-102.Kim J.H., Byun H.J., Ann J.H., et al. Relationship between subjective experiences and psychopathological dimensions in schizophrenics. Aust N Z J Psychiat. — 2010. — Vol.44. — P.952-957.Kim J.H., Byun H.J., Ann J.H., et al. Relationship between subjective experiences and psychopathological dimensions in schizophrenics. Aust N Z J Psychiat. — 2010. — Vol.44. — P.952-957.Lindenmayer J.P., McGurk S.R., Khan A., et al. Improvement of social cognition in schizophrenia:a pilot intervention combining computerized social cognition training with cognitive remediation. Schizophr. Bull. — 2017. — Vol.39. — P.507-517. DOI:10.1093/schbul/sbs120.Lindenmayer J.P., McGurk S.R., Khan A., et al. Improvement of social cognition in schizophrenia:a pilot intervention combining computerized social cognition training with cognitive remediation. Schizophr. Bull. — 2017. — Vol.39. — P.507-517. DOI:10.1093/schbul/sbs120.Lindenmayer J.P., Khan A., McGurk S.R., et al. Does social cognition training augment respond to computer assisted cognitive remediation for schizophrenia? Schizophr. Res. — 2018. — Vol.201. — P.180-186. DOI: 10.1016/j.schres.2018.06.012.Lindenmayer J.P., Khan A., McGurk S.R., et al. Does social cognition training augment respond to computer assisted cognitive remediation for schizophrenia? Schizophr. Res. — 2018. — Vol.201. — P.180-186. DOI: 10.1016/j.schres.2018.06.012.Lyman DR., Kurtz MM., Farkas M., Dougherty RH., Daniels AS., et al. Skill building: assessing the evidence. Psychiatr Serv. — 2014. — Vol.65. — P.727-738. DOI:10.1176/appi.ps.201300251Lyman DR., Kurtz MM., Farkas M., Dougherty RH., Daniels AS., et al. Skill building: assessing the evidence. Psychiatr Serv. — 2014. — Vol.65. — P.727-738. DOI:10.1176/appi.ps.201300251Medalia A., Thysen J. Insight into neurocognitive dysfunction in schizophrenia. Schizophr. Bull. — 2008. — Vol.34. — P.1221-1230. DOI:10.1093/schbul/sbm144.Medalia A., Thysen J. Insight into neurocognitive dysfunction in schizophrenia. Schizophr. Bull. — 2008. — Vol.34. — P.1221-1230. DOI:10.1093/schbul/sbm144.Mehta U.M., Thirthalli J., Subbakrishna D.K., et al. Social and neurocognition as distinct cognitive factors in schizophrenia: a systematic review. Schizophr. Res. — 2013. — Vol.148. — P.3-11. DOI:10.1016/schres.2013.05.009.Mehta U.M., Thirthalli J., Subbakrishna D.K., et al. Social and neurocognition as distinct cognitive factors in schizophrenia: a systematic review. Schizophr. Res. — 2013. — Vol.148. — P.3-11. DOI:10.1016/schres.2013.05.009.Naber D. Subjective effects of antipsychotic treatment. Acta Psychiatr Scand. — 2005. — Vol.111(2). — P.81-83. DOI:10.1111/j.1600-0447.2004.0047x.Naber D. Subjective effects of antipsychotic treatment. Acta Psychiatr Scand. — 2005. — Vol.111(2). — P.81-83. DOI:10.1111/j.1600-0447.2004.0047x.Nahum M., Fisher M., Loewy K., et al. A novel, online cognitive training program for young adults with schizophrenia: a pilot study. Schizophrenia Research: Cognition. –2014. — Vol.1(1). — P.11-19. DOI:10.1016/j.scog.2014.01.003.Nahum M., Fisher M., Loewy K., et al. A novel, online cognitive training program for young adults with schizophrenia: a pilot study. Schizophrenia Research: Cognition. –2014. — Vol.1(1). — P.11-19. DOI:10.1016/j.scog.2014.01.003.Palumbo D., Mucci A., Piegari G., et al. SoCIAL training cognition in schizophrenia — a pilot study. Neuropsychiatr. Dis. Treat. — 2017. — Vol.13. — P.1947-1956. DOI:10.2147/NDT.S136732.Palumbo D., Mucci A., Piegari G., et al. SoCIAL training cognition in schizophrenia — a pilot study. Neuropsychiatr. Dis. Treat. — 2017. — Vol.13. — P.1947-1956. DOI:10.2147/NDT.S136732.Penn D.L., Spaulding W., Reed D., Sullivan M. The relationship of social cognition to ward behavior in chronic schizophrenia. Schizophr. Res. — 1996. — Vol.20. — P.327-335. DOI:10.1016/0920-9964(96)00010-2.Penn D.L., Spaulding W., Reed D., Sullivan M. The relationship of social cognition to ward behavior in chronic schizophrenia. Schizophr. Res. — 1996. — Vol.20. — P.327-335. DOI:10.1016/0920-9964(96)00010-2.Prouteau A., Verdoux H., Briand C., et al. Cognitive predictions of psychosocial functioning outcome in schizophrenia: a follow-up subjects participating in a rehabilitation program. — Schizophr. Res. — 2005. –Vol.77. — P.343-353. DOI: j.schres.2005.03.001Prouteau A., Verdoux H., Briand C., et al. Cognitive predictions of psychosocial functioning outcome in schizophrenia: a follow-up subjects participating in a rehabilitation program. — Schizophr. Res. — 2005. –Vol.77. — P.343-353. DOI: j.schres.2005.03.001Reeder C., Smedley N., Butt K., et al. Cognitive predictors of social functioning improvements following cognitive remediation for schizophrenia. Schizophr. Bull. –2006. –Vol.32. — P.123- 131. DOI:10.1093/schbul/sbl019.Reeder C., Smedley N., Butt K., et al. Cognitive predictors of social functioning improvements following cognitive remediation for schizophrenia. Schizophr. Bull. –2006. –Vol.32. — P.123- 131. DOI:10.1093/schbul/sbl019.Rich M., Caldwell H. A role of oxytocin in the etiology and treatment of schizophrenia. Front. Endocrinol. — 2015. — Vol.6. — P.90. DOI:10.3389/fendo.2015.00090.Rich M., Caldwell H. A role of oxytocin in the etiology and treatment of schizophrenia. Front. Endocrinol. — 2015. — Vol.6. — P.90. DOI:10.3389/fendo.2015.00090.Roberts D.L., Velligan D.I. Can social functioning in schizophrenia be improved through targeted social cognition intervention? Rehabilitation Research and Practice. — 2012. — Article ID742106. DOI:10.1155/2012/742106.Roberts D.L., Velligan D.I. Can social functioning in schizophrenia be improved through targeted social cognition intervention? Rehabilitation Research and Practice. — 2012. — Article ID742106. DOI:10.1155/2012/742106.Rund B.R., Borg N.E. Cognitive deficits and cognitive training in schizophrenic patients: a review. Acta Psychiat. Scand. — 1999. — Vol.100. — P. 85-95. DOI:10.1111/j.1600-0447.1999.tb10829.x.Rund B.R., Borg N.E. Cognitive deficits and cognitive training in schizophrenic patients: a review. Acta Psychiat. Scand. — 1999. — Vol.100. — P. 85-95. DOI:10.1111/j.1600-0447.1999.tb10829.x.Savla G.N., Vell L., Armstrong C.C., et al. Deficits in domains of social cognition in schizophrenia: a meta-analysis of the empirical evidence. Schizophrenia Bull. — 2013. — Vol.39 (5). — P.979-992. DOI:10.1093/schbul/sbs080.Savla G.N., Vell L., Armstrong C.C., et al. Deficits in domains of social cognition in schizophrenia: a meta-analysis of the empirical evidence. Schizophrenia Bull. — 2013. — Vol.39 (5). — P.979-992. DOI:10.1093/schbul/sbs080.Schmidt S.J., Mueller D.R., Roder V. Social cognition as a mediator variable between neurocognition and functional outcome in schizophrenia: empirical review and new results by structural equation modeling. Schizophr. Bull. — 2011. — Vol37. — P.41-54. DOI:10.1093/schbul/sbr079.Schmidt S.J., Mueller D.R., Roder V. Social cognition as a mediator variable between neurocognition and functional outcome in schizophrenia: empirical review and new results by structural equation modeling. Schizophr. Bull. — 2011. — Vol37. — P.41-54. DOI:10.1093/schbul/sbr079.Shilling P., Feifel D. Potential of oxytocin in the treatment of schizophrenia. — CNS Drugs. — 2016. — Vol.30(3). — P.193-208. DOI:10.1007/s40263-016-0315-xShilling P., Feifel D. Potential of oxytocin in the treatment of schizophrenia. — CNS Drugs. — 2016. — Vol.30(3). — P.193-208. DOI:10.1007/s40263-016-0315-xShin Y.J., Yoo Y.H., Kim Y.H. Self-perceived cognitive deficits and their relationship with internalized stigma and quality of life in patients with schizophrenia. — Neuropsychiatr. Disease. Treat. — 2016. — Vol.12. — P.1411-1417. DOI:10.2147/NDT.S108537.Shin Y.J., Yoo Y.H., Kim Y.H. Self-perceived cognitive deficits and their relationship with internalized stigma and quality of life in patients with schizophrenia. — Neuropsychiatr. Disease. Treat. — 2016. — Vol.12. — P.1411-1417. DOI:10.2147/NDT.S108537.Sterea R. The relationship between social condition and functional outcomes in schizophrenia. — Procedia — Social and Behavioral Sciences. — 2015. — Vol.187. — P.256-260. DOI:10.1016/j.sbspro.2015.03.048.Sterea R. The relationship between social condition and functional outcomes in schizophrenia. — Procedia — Social and Behavioral Sciences. — 2015. — Vol.187. — P.256-260. DOI:10.1016/j.sbspro.2015.03.048.Subramaniam K., Luks T.L., Garret C.,et al. Intensive cognitive training in schizophrenia enhances working memory and associated prefrontal cortical efficiency in a manner that drives long-term functional gains. — Neuroimage. — 2014. –Vol.99. — P. 81-292. Doi:10.106/j.neuroimage.2014.05.057.Subramaniam K., Luks T.L., Garret C.,et al. Intensive cognitive training in schizophrenia enhances working memory and associated prefrontal cortical efficiency in a manner that drives long-term functional gains. — Neuroimage. — 2014. –Vol.99. — P. 81-292. Doi:10.106/j.neuroimage.2014.05.057.Tripathi А. et al. Cognitive deficits in schizophrenia: understanding the biological correlates and remediation strategies. Clin. Psychopharmacol. Neurosci. — 2018. — Vol.16. — P.7-17. DOI:10.9758/cpn.2018.16.1.7.Tripathi А. et al. Cognitive deficits in schizophrenia: understanding the biological correlates and remediation strategies. Clin. Psychopharmacol. Neurosci. — 2018. — Vol.16. — P.7-17. DOI:10.9758/cpn.2018.16.1.7.Vauth R., Rusch N., Wirtz M., Corrigan P.W. Does social cognitive influence the relation between neurocognitive deficits and vocational functioning in schizophrenia? Psychiatr. Res. — 2004. — Vol.128. — P.155-165. DOI:10.1016/j.psychres.2004.05.018.Vauth R., Rusch N., Wirtz M., Corrigan P.W. Does social cognitive influence the relation between neurocognitive deficits and vocational functioning in schizophrenia? Psychiatr. Res. — 2004. — Vol.128. — P.155-165. DOI:10.1016/j.psychres.2004.05.018.Velligan D. I., Prihoda T.J., Sui D., et al. The effectiveness of quetiapine versus conventional antipsychotics in improving cognitive and functional outcomes in standard treatment settings. J. Clin. Psychiatry. — 2003. — Vol. 64(5). — P.524-531.Velligan D. I., Prihoda T.J., Sui D., et al. The effectiveness of quetiapine versus conventional antipsychotics in improving cognitive and functional outcomes in standard treatment settings. J. Clin. Psychiatry. — 2003. — Vol. 64(5). — P.524-531.Verdoux H., Monello E., Goumilloux A., et al. Self-perceived cognitive deficit and occupational outcome in persons with schizophrenia. Psychiat. Res. — 2010 Jul. — Vol.178. — P.437-439. DOI:10.1016/j.psychres.2010.04.031.Verdoux H., Monello E., Goumilloux A., et al. Self-perceived cognitive deficit and occupational outcome in persons with schizophrenia. Psychiat. Res. — 2010 Jul. — Vol.178. — P.437-439. DOI:10.1016/j.psychres.2010.04.031.Wiener D., Rybakowski J. Disturbances of social cognition in schizophrenia. Psychiatr. Pol. — 2006. — Vol.40. — P.205-218.Wiener D., Rybakowski J. Disturbances of social cognition in schizophrenia. Psychiatr. Pol. — 2006. — Vol.40. — P.205-218.

The authors declare that there are no conflicts of interest present.