Publication: Cognición y síntomas negativos en la esquizofrenia
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2017-02-08
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Universidad Complutense de Madrid
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Abstract
Aunque los delirios y alucinaciones, también denominados síntomas positivos, se han considerado como los más característicos de la esquizofrenia y tradicionalmente han supuesto la diana de los tratamientos para el trastorno, hoy en día se conoce que no son éstos los síntomas más ligados al pronóstico y funcionalidad de los pacientes. En los últimos años se ha puesto de manifiesto que los denominados síntomas negativos (que incluyen aspectos como la abulia, la asociabilidad, la anhedonia, la alogia o el aplanamiento afectivo) y la disfunción cognitiva (que afecta de manera generalizada al rendimiento cognitivo de los pacientes) están mucho más estrechamente ligados a la funcionalidad de las personas con esquizofrenia que los síntomas positivos, y tienen implicaciones pronósticas muy importantes. Los síntomas negativos y cognitivos presentan algunos aspectos similares, como su cualidad nuclear en la esquizofrenia, su presencia desde el inicio del trastorno e incluso antes de la aparición de los síntomas positivos, su independencia de estos síntomas positivos, su persistencia temporal, su escasa respuesta a los tratamientos antipsicóticos actuales, o su estrecha relación con el funcionamiento y el pronóstico de los pacientes. La relación entre cognición y síntomas negativos ha sido estudiada por diferentes autores. Aunque en general se ha descrito una asociación débil, la literatura muestra hallazgos contradictorios. En este sentido, se ha destacado la relevancia de diversos factores, en especial de tipo metodológico, a la hora de estudiar la relación entre estas dos dimensiones clínicas de la esquizofrenia. Así pues, dada la trascendencia pronóstica de la cognición y los síntomas negativos en la esquizofrenia, y los hallazgos contradictorios descritos en la literatura acerca de su asociación, la presente tesis se propuso estudiar la relación entre ambos tipos de síntomas y los factores que influyen en la misma...
Delusions and hallucinations, also called positive symptoms, have been considered to be the most characteristic manifestations of schizophrenia and have traditionally been the goal of treatments for the disorder. However, it is currently accepted that these are not the symptoms that are most associated with patients’ prognosis and functioning. In the last years the so-called negative symptoms (which include aspects such as avolition, asociality, anhedonia, alogia or affective flattening) and cognitive dysfunction (which leads to generalized impairments in patients’ cognitive performance) have been shown to be much more closely related to functional outcome in patients with schizophrenia, and to have very important prognostic implications. Negative and cognitive symptoms share some common features: they are considered to be nuclear in schizophrenia, they are present from disease onset and even before the appearance of positive symptoms, they are independent from these positive symptoms, they are persistent over time, they show little response to current antipsychotic treatments, and they are closely related to patients’ functioning and prognosis. Different authors have studied the relationship between cognition and negative symptoms. Although a weak association has generally been described, there are contradictory findings in the literature. In this respect, the importance of different methodological factors when studying the relationship between these two clinical dimensions of schizophrenia has been highlighted. Thus, given the prognostic relevance of cognition and negative symptoms in schizophrenia and the contradictory findings in the literature regarding their association, the present dissertation aimed to study the relationship between these two symptoms domains and the factors influencing this relationship...
Delusions and hallucinations, also called positive symptoms, have been considered to be the most characteristic manifestations of schizophrenia and have traditionally been the goal of treatments for the disorder. However, it is currently accepted that these are not the symptoms that are most associated with patients’ prognosis and functioning. In the last years the so-called negative symptoms (which include aspects such as avolition, asociality, anhedonia, alogia or affective flattening) and cognitive dysfunction (which leads to generalized impairments in patients’ cognitive performance) have been shown to be much more closely related to functional outcome in patients with schizophrenia, and to have very important prognostic implications. Negative and cognitive symptoms share some common features: they are considered to be nuclear in schizophrenia, they are present from disease onset and even before the appearance of positive symptoms, they are independent from these positive symptoms, they are persistent over time, they show little response to current antipsychotic treatments, and they are closely related to patients’ functioning and prognosis. Different authors have studied the relationship between cognition and negative symptoms. Although a weak association has generally been described, there are contradictory findings in the literature. In this respect, the importance of different methodological factors when studying the relationship between these two clinical dimensions of schizophrenia has been highlighted. Thus, given the prognostic relevance of cognition and negative symptoms in schizophrenia and the contradictory findings in the literature regarding their association, the present dissertation aimed to study the relationship between these two symptoms domains and the factors influencing this relationship...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Psiquiatría, leída el 17-12-2016