TITLE:
Resilience Improves Neurocognition and Treatment Outcomes in Schizophrenia: A Hypothesis
AUTHORS:
Amresh Shrivastava, Avinash De Sousa, Sushma Sonavane, Nilesh Shah
KEYWORDS:
Resilience, Cognition, Neurocognition, Schizophrenia, Outcomes
JOURNAL NAME:
Open Journal of Psychiatry,
Vol.6 No.2,
April
6,
2016
ABSTRACT: There has been a
revolutionary advance in the treatment and management of schizophrenia from a
clinical aspect yet the social and functional outcomes remain poor. Cognitive
function is impaired in schizophrenia and shows various domains of dysfunction
like verbal memory, processing speed and working memory. It is also known to be
a factor associated with poor outcome in schizophrenia. Resilience is a new
concept psychobiological concept which is defined as individual’s ability to
adapt swiftly to adverse life events and bounces back to normalcy. Resilience
has genetic, neurobiological, neurochemical and psychological underpinnings. It
is the ability to effectively deal with psychosocial stressors and appears to
be one of the many factors associated with favourable outcomes in
schizophrenia. Besides several neurobiological abnormalities associated with
resilience, neucognitive functions are of particular interest. Persistent
psychosocial stressors also lead to significant neurobiological changes which
may be synergetic to poor outcome due to cognitive changes. Though there has
been extensive research in the field of cognitive function in schizophrenia, the
trajectory of its pathway of poor outcome remains undetermined. Resilience
being a protective factor may be one of the psychobiological functions which
modulate the effect of neurocognition on the outcome of schizophrenia. There
has been some success with interventions aimed at improving cognitive function
in schizophrenia whether pharmacological or non pharmacological. In this paper,
we discuss a hypothesis that resilience may be a “linkage” between cognition
and outcome. There is a need for interventions aimed at increasing resilience
in patients with schizophrenia and we hypothesize giving evidence that this may
in turn improve outcome and neurocognitive functioning in schizophrenia.