Cognitive deficits, obesity and disability in schizophrenia

Despite 50 years of pharmacological and psychosocial interventions schizophrenia remains one of the leading causes of disability. The inability to function in everyday settings includes deficits in performance of social, occupational, and independent living activities. Schizophrenia is also a life-shortening illness, caused mainly by poor physical health and its complications. Dysfunctional lifestyles including sedentary behavior and lack of physical activity prevail, while treatment with adipogenic antipsychotic medication interacts with poor performance in screening, monitoring, and intervention that result in shortening of life expectancies by 25–30 years. Disability interferes with self-care and medical care, further worsening physical health to produce a vicious cycle of disability. Further, the neurobiological impact of obesity on brain functioning is substantial and relevant to schizophrenia. Decision making deficits that lead to choices resulting in obesity themselves have neurobiological determinants. Simultaneous treatment of cognitive deficits and related deficits in functional skills, ubiquitous determinants of everyday functioning in schizophrenia, and targeted interventions aimed at poor physical health, especially obesity and associated comorbidities, may lead to additive or even interactive gains in everyday functioning in patients with schizophrenia not previously realized with other interventions.

[1]  T L Patterson,et al.  UCSD Performance-Based Skills Assessment , 2016 .

[2]  David Cucurell,et al.  Neurophysiological Differences in Reward Processing in Anhedonics , 2022 .

[3]  M. Cannon,et al.  Neurocognitive performance of a community-based sample of young people at putative ultra high risk for psychosis: Support for the processing speed hypothesis , 2013, Cognitive neuropsychiatry.

[4]  D. Vancampfort,et al.  Associations between sedentary behaviour and metabolic parameters in patients with schizophrenia , 2012, Psychiatry Research.

[5]  R. Ganguli,et al.  Health-related quality of life, adiposity, and sedentary behavior in patients with early schizophrenia: preliminary study , 2012, Diabetes, metabolic syndrome and obesity : targets and therapy.

[6]  J. Buckley,et al.  Dairy consumption and working memory performance in overweight and obese adults , 2012, Appetite.

[7]  Philip D. Harvey,et al.  Combined cognitive remediation and functional skills training for schizophrenia: effects on cognition, functional competence, and real-world behavior. , 2012, The American journal of psychiatry.

[8]  B. Frier,et al.  Diabetes and cognitive dysfunction , 2012, The Lancet.

[9]  S. Kanoski.  Cognitive and neuronal systems underlying obesity , 2012, Physiology & Behavior.

[10]  Philip D. Harvey,et al.  Predicting the severity of everyday functional disability in people with schizophrenia: cognitive deficits, functional capacity, symptoms, and health status , 2012, World psychiatry : official journal of the World Psychiatric Association.

[11]  D. Barch,et al.  Pavlovian Reward Prediction and Receipt in Schizophrenia: Relationship to Anhedonia , 2012, PloS one.

[12]  C. Jack,et al.  Modifiable factors that alter the size of the hippocampus with ageing , 2012, Nature Reviews Neurology.

[13]  Hidehiko Takahashi,et al.  Effects of sports participation on psychiatric symptoms and brain activations during sports observation in schizophrenia , 2012, Translational Psychiatry.

[14]  C. Bowie,et al.  Functional outcomes in schizophrenia: understanding the competence-performance discrepancy. , 2012, Journal of psychiatric research.

[15]  O. Grimm,et al.  Reduced striatal activation during reward anticipation due to appetite-provoking cues in chronic schizophrenia: A fMRI study , 2012, Schizophrenia Research.

[16]  A. Der-Avakian,et al.  The neurobiology of anhedonia and other reward-related deficits , 2012, Trends in Neurosciences.

[17]  C. Correll,et al.  Weight gain and metabolic risks associated with antipsychotic medications in children and adolescents. , 2011, Journal of child and adolescent psychopharmacology.

[18]  J. Wells,et al.  Intentional weight loss in overweight and obese individuals and cognitive function: a systematic review and meta‐analysis , 2011, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[19]  E. McNay,et al.  Brain insulin signaling: A key component of cognitive processes and a potential basis for cognitive impairment in type 2 diabetes , 2011, Neurobiology of Learning and Memory.

[20]  Á. Pascual-Leone,et al.  The neurocognitive connection between physical activity and eating behaviour , 2011, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[21]  S. Silverstein,et al.  Report from the working group conference on multisite trial design for cognitive remediation in schizophrenia. , 2011, Schizophrenia bulletin.

[22]  Daniel J Fridberg,et al.  Temporal discounting of rewards in patients with bipolar disorder and schizophrenia. , 2011, Journal of abnormal psychology.

[23]  Eric Stice,et al.  An fMRI study of obesity, food reward, and perceived caloric density. Does a low-fat label make food less appealing? , 2011, Appetite.

[24]  R. Rosenheck,et al.  Association of psychiatric illness and obesity, physical inactivity, and smoking among a national sample of veterans. , 2011, Psychosomatics.

[25]  Vyv Huddy,et al.  A Meta-Analysis of Cognitive Remediation for Schizophrenia: Methodology and Effect Sizes , 2012 .

[26]  R. Ganguli,et al.  Prevention of metabolic syndrome in serious mental illness. , 2011, The Psychiatric clinics of North America.

[27]  R. Ganguli,et al.  Low cardiorespiratory fitness and physical functional capacity in obese patients with schizophrenia , 2011, Schizophrenia Research.

[28]  Derek V. Taylor,et al.  Elevated BMI Is Associated With Decreased Blood Flow in the Prefrontal Cortex Using SPECT Imaging in Healthy Adults , 2011, Obesity.

[29]  David Hevey,et al.  Impaired decision making among morbidly obese adults. , 2011, Journal of psychosomatic research.

[30]  D. Jeste,et al.  Increased Framingham 10-year risk of coronary heart disease in middle-aged and older patients with psychotic symptoms , 2011, Schizophrenia Research.

[31]  I. Hajjar,et al.  The relationship between blood pressure and cognitive function , 2010, Nature Reviews Cardiology.

[32]  Philip D. Harvey,et al.  The effects of hypertension and body mass index on cognition in schizophrenia. , 2010, American Journal of Psychiatry.

[33]  Rena R Wing,et al.  Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. , 2010, Archives of internal medicine.

[34]  Philip D. Harvey,et al.  Prediction of real-world functional disability in chronic mental disorders: a comparison of schizophrenia and bipolar disorder. , 2010, The American journal of psychiatry.

[35]  M. Styner,et al.  Aerobic fitness and obesity: relationship to cerebral white matter integrity in the brain of active and sedentary older adults , 2010, British Journal of Sports Medicine.

[36]  G. Kranz,et al.  Reward and the serotonergic system , 2010, Neuroscience.

[37]  Peter Falkai,et al.  Hippocampal plasticity in response to exercise in schizophrenia. , 2010, Archives of general psychiatry.

[38]  Sohee Park,et al.  Relative food preference and hedonic judgments in schizophrenia , 2010, Psychiatry Research.

[39]  Lee Ryan,et al.  Structural brain differences and cognitive functioning related to body mass index in older females , 2009, Human brain mapping.

[40]  V. Haroutunian,et al.  The effects of cardiovascular risk factors on cognitive compromise , 2009, Dialogues in clinical neuroscience.

[41]  L. Kappelle,et al.  Type 2 diabetes mellitus, hypertension, dyslipidemia and obesity: A systematic comparison of their impact on cognition. , 2009, Biochimica et biophysica acta.

[42]  A. Drewnowski,et al.  Energy density, palatability, and satiety: implications for weight control. , 2009, Nutrition reviews.

[43]  Rita Z. Goldstein,et al.  Inverse Association Between BMI and Prefrontal Metabolic Activity in Healthy Adults , 2009, Obesity.

[44]  Yu-Shin Ding,et al.  Low dopamine striatal D2 receptors are associated with prefrontal metabolism in obese subjects: Possible contributing factors , 2008, NeuroImage.

[45]  A. Boeka,et al.  Neuropsychological performance of a clinical sample of extremely obese individuals. , 2008, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[46]  J. Gold,et al.  Decision-Making Impairments in the Context of Intact Reward Sensitivity in Schizophrenia , 2008, Biological Psychiatry.

[47]  K. Berridge,et al.  Affective neuroscience of pleasure: reward in humans and animals , 2008, Psychopharmacology.

[48]  F. Dickerson,et al.  Evidence of exacerbated cognitive deficits in schizophrenia patients with comorbid diabetes. , 2008, Psychosomatics.

[49]  Philip D. Harvey,et al.  Predicting Schizophrenia Patients’ Real-World Behavior with Specific Neuropsychological and Functional Capacity Measures , 2008, Biological Psychiatry.

[50]  J. Newcomer.  Metabolic syndrome and mental illness. , 2007, The American journal of managed care.

[51]  J. Newcomer,et al.  Severe mental illness and risk of cardiovascular disease. , 2007, JAMA.

[52]  R. Ganguli,et al.  Weight Loss Interventions for Patients with Schizophrenia , 2007 .

[53]  J. Aldenhoff,et al.  Delay of gratification and executive performance in individuals with schizophrenia: putative role for eating behavior and body weight regulation. , 2007, Journal of psychiatric research.

[54]  Philip D. Harvey,et al.  Performance-based measures of functional skills: usefulness in clinical treatment studies. , 2007, Schizophrenia bulletin.

[55]  Benjamin M. Robinson,et al.  Delay discounting in schizophrenia , 2007, Cognitive neuropsychiatry.

[56]  R. Ganguli.  Behavioral therapy for weight loss in patients with schizophrenia. , 2007, The Journal of clinical psychiatry.

[57]  B. Druss,et al.  Challenges and solutions to integrating mental and physical health care. , 2007, The Journal of clinical psychiatry.

[58]  R. Ganguli,et al.  Increased caffeine and nicotine consumption in community-dwelling patients with schizophrenia , 2006, Schizophrenia Research.

[59]  Kewei Chen,et al.  Brain abnormalities in human obesity: A voxel-based morphometric study , 2006, NeuroImage.

[60]  D. Borsook,et al.  Food Intake and Reward Mechanisms in Patients with Schizophrenia: Implications for Metabolic Disturbances and Treatment with Second-Generation Antipsychotic Agents , 2006, Neuropsychopharmacology.

[61]  Robert K. Heaton,et al.  Determinants of real-world functional performance in schizophrenia subjects: correlations with cognition, functional capacity, and symptoms. , 2006, The American journal of psychiatry.

[62]  C. Hennekens,et al.  Schizophrenia and increased risks of cardiovascular disease. , 2005, American heart journal.

[63]  G. Biessels,et al.  The impact of diabetes on cognition: What can be learned from rodent models? , 2005, Neurobiology of Aging.

[64]  J. Lieberman,et al.  Prevalence of the metabolic syndrome in patients with schizophrenia: Baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III , 2005, Schizophrenia Research.

[65]  M. Connolly,et al.  Dietary improvement in people with schizophrenia: randomised controlled trial. , 2005, The British journal of psychiatry : the journal of mental science.

[66]  Philip D. Harvey,et al.  Cognition in schizophrenia: impairments, determinants, and functional importance. , 2005, The Psychiatric clinics of North America.

[67]  R. Ganguli,et al.  Dietary fatty acid and antioxidant intake in community-dwelling patients suffering from schizophrenia , 2005, Schizophrenia Research.

[68]  R. Ganguli,et al.  Self-reported body weight perception and dieting practices in community-dwelling patients with schizophrenia , 2005, Schizophrenia Research.

[69]  J. Newcomer.  Metabolic risk during antipsychotic treatment. , 2004, Clinical therapeutics.

[70]  Emmanuel Stip,et al.  Assessment of executive dysfunction during activities of daily living in schizophrenia , 2004, Schizophrenia Research.

[71]  Nora D Volkow,et al.  Similarity Between Obesity and Drug Addiction as Assessed by Neurofunctional Imaging , 2004, Journal of addictive diseases.

[72]  M. Davidson,et al.  Cognitive performance in schizophrenia patients assessed before and following the first psychotic episode , 2003, Schizophrenia Research.

[73]  P. Durlach,et al.  The effect of retrograde and anterograde glucose administration on memory performance in healthy young adults , 2002, Behavioural Brain Research.

[74]  S. Fowler,et al.  Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. , 2002, The New England journal of medicine.

[75]  R. Gur,et al.  Striatal dopamine transporters and cognitive functioning in healthy men and women. , 2001, The American journal of psychiatry.

[76]  J. Birtwistle,et al.  The unhealthy lifestyle of people with schizophrenia , 1999, Psychological Medicine.

[77]  S B Roberts,et al.  Dietary variety within food groups: association with energy intake and body fatness in men and women. , 1999, The American journal of clinical nutrition.

[78]  N. Volkow,et al.  Dopamine transporter occupancies in the human brain induced by therapeutic doses of oral methylphenidate. , 1998, The American journal of psychiatry.

[79]  R. McCreadie,et al.  Dietary intake of schizophrenic patients in Nithsdale, Scotland: case-control study , 1998, BMJ.

[80]  N. Volkow,et al.  Association between decline in brain dopamine activity with age and cognitive and motor impairment in healthy individuals. , 1998, The American journal of psychiatry.

[81]  Alan D. Lopez,et al.  Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study , 1997, The Lancet.

[82]  A. Nehlig,et al.  Cerebral energy metabolism, glucose transport and blood flow: changes with maturation and adaptation to hypoglycaemia. , 1997, Diabetes & metabolism.

[83]  Nora D. Volkow,et al.  Dr. Volkow and Colleagues Reply , 1987 .

[84]  S. Vinogradov,et al.  Cognitive Training for Impaired Neural Systems in Neuropsychiatric Illness , 2012, Neuropsychopharmacology.

[85]  Philip D. Harvey.  Cognitive impairment in schizophrenia: profile, course, and neurobiological determinants. , 2012, Handbook of clinical neurology.

[86]  James J Levitt,et al.  A selective review of volumetric and morphometric imaging in schizophrenia. , 2010, Current topics in behavioral neurosciences.

[87]  Daniel M. Hartung,et al.  Metabolic testing rates in 3 state Medicaid programs after FDA warnings and ADA/APA recommendations for second-generation antipsychotic drugs. , 2010, Archives of general psychiatry.

[88]  Daniele Sancarlo,et al.  Metabolic syndrome and cognitive impairment: current epidemiology and possible underlying mechanisms. , 2010, Journal of Alzheimer's disease : JAD.

[89]  Michael F. Green,et al.  Cognitive impairment and functional outcome in schizophrenia and bipolar disorder. , 2006, The Journal of clinical psychiatry.

[90]  D. Borsook,et al.  Is There Such Thing as a Schizophrenic Stomach? , 2006, Neuropsychopharmacology.

[91]  J. Newcomer,et al.  Antipsychotic-induced weight gain and metabolic abnormalities: implications for increased mortality in patients with schizophrenia. , 2004, The Journal of clinical psychiatry.

[92]  R. Ganguli,et al.  Nutritional assessment of patients with schizophrenia: a preliminary study. , 2003, Schizophrenia bulletin.

[93]  N. Volkow,et al.  Association between age-related decline in brain dopamine activity and impairment in frontal and cingulate metabolism. , 2000, The American journal of psychiatry.

[94]  D. Braff,et al.  Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the "right stuff"? , 2000, Schizophrenia bulletin.

[95]  B. Popkin,et al.  Diet quality index: capturing a multidimensional behavior. , 1994, Journal of the American Dietetic Association.