Time to Re-focus onto Cognitive Symptoms in Schizophrenia

Low IQ and poor scholastic performance increase the risk for developing schizophrenia in a dose-response fashionThere is a progressive cognitive decline between the ages 7 and 13 in people who go onto develop schizophrenia, which starts at least a decade before the onset of psychotic symptomsThere is significantly lesser increase in cognition in patients compared to controls and larger degree of cognitive impairment in patients than that is observed before the onset of psychosis suggesting that cognitive performance may continue to decline after the onset of psychotic symptomsThe mean cognitive underperformance during adolescence and at the onset of psychotic symptoms differentiates schizophrenia from the other major psychotic illness and bipolar disorder. Change in drug target Dopamine hypothesis which was the focus of drug discovery over the last six decades has now given place to newer hypothesis such as the N-methyl-D-aspartate receptor (NMDAR) hypofunction hypothesis and the modified dopamine hypothesis which give importance to glutamine and serotonin function, respectively.