Alejandra Sánchez, Julián Andrés Ramírez Euse
, Deisy Elizabeth Ochoa Jiménez
La presente investigación busca identificar los determinantes asociados a la psicopatología con mayor efecto sobre el funcionamiento cognitivo en la esquizofrenia. Como metodología se siguió las directrices establecidas en el informe de elementos para revisiones sistemáticas y metaanálisis PRISMA versión 2020 y las bases de datos utilizadas fueron: ScienceDirect, Ebsco, Scopus, Redalyc, DOAJ, Dialnet, Elseiver, PudMed y APA PsycArticles. Se identificaron 175 artículos publicados entre el 2016 y el 2021, los cuales se evaluaron con la Escala para Evaluar Artículos Científicos en Ciencias Sociales y Humanas (EACSH), para una muestra final de 44 artículos. En los resultados se determinaron seis categorías emergentes: (1) cognición asociada a la dosis de antipsicótico; (2) cognición asociada al tipo de antipsicótico; (3) interacción entre cognición y adherencia al medicamento; (4) cognición asociada a la medicación de apoyo; (5) cognición asociada a la fase de la enfermedad; y (6) intervención neurocognitiva como factor protector de https://doi.org/10.16888/interd.2023.40.3.1 Cognición en la esquizofrenia. Revisión sistemática la cognición. Se concluye que hubo poco consenso científico sobre los factores farmacológicos que influyen en el deterioro cognitivo. Al parecer, un peor funcionamiento cognitivo en la esquizofrenia se relaciona con: la cronicidad de la enfermedad, con la fase de no remisión sintomática y con el tipo de esquizofrenia.
Schizophrenia is one of the most serious pathologies at the mental level worldwide, representing a prevalence of 7 people out of every 1,000 in the world. It is estimated that this disease affects more than 21 million people worldwide, with a higher proportion of cases in men, with onset of symptoms between late adolescence and 30 years of age. It is a highly disabling diagnosis, with a frequency of more than 25 percent of cases, generating negative emotional, social and economic impact for the patient, caregivers, social environment and health system, affecting the work, social and educational performance of the schizophrenic person, resulting in cognitive deficits that persist despite the disappearance of symptoms, contributing to the patient's disability and helplessness. Objective: to trace the determinants associated with psychopathology, which have the greatest effect on cognitive functioning in schizophrenia, in empirical scientific studies published between 2016 and 2021. Method: The present research was constructed with the application of the protocols and guidelines established in the report of elements for systematic reviews and meta-analysis PRISMA, the databases used to locate relevant articles were:
ScienceDirect, Ebsco, Scopus, Redalyc, DOAJ, Dialnet, Elseiver, PudMed and APA PsycArticles. The inclusion criteria with which the search was limited, required articles published between 2016 and 2021, that is, the last 5 years, 2,342 articles were identified in the https://doi.org/10.16888/interd.2023.40.3.1 Cognición en la esquizofrenia. Revisión sistemática databases, which corresponded to empirical studies and documentary studies, such as systematic reviews, meta-analyses and theoretical reflections. After eliminating duplicates and articles by topic of interest, 175 publications were identified and evaluated with the EACSH instrument.
The selection of articles was made by title, abstract and finally by total content of the article. The definitive sample was composed of 44 articles, which were then included in a categorical matrix where they proceeded to the analysis of information and generation of results. Ethical considerations: The article is based on the Colombian legal framework on copyright (Law 23 of 1982), and the Deontological and Bioethical Code of the psychology profession (Law 1090 of 2006), at the international level on the ethical principles and codes of conduct of the 2010 APA amendment, and on the intellectual property rights adopted by the WIPO according to the Berne Convention of 1886. Results: 6 emerging categories were established: cognition associated with antipsychotic dose, cognition associated with the type of antipsychotic, interaction between cognition and medication adherence, cognition associated with supportive medication, cognition associated with the phase of the disease, neurocognitive intervention as a protective factor of cognition. Discussion: there are concordances with previous studies that argue global alteration in cognition in schizophrenic patients, due to high doses and chronicity in the use of antipsychotics. There is also convergence with previous studies, identifying that cognition is influenced by the phase of the disease. Conclusions: cognition is a highly compromised aspect in schizophrenia, in which its alterations can manifest before the appearance of positive and negative symptoms, and which persists even when the nuclear symptoms disappear. There is little scientific consensus on the pharmacological factors that positively or negatively influence cognitive impairment, it seems that worse cognitive functioning in people with schizophrenia is related to the chronicity of the disease, the phase of symptomatic non-remission, and the type of https://doi.org/10.16888/interd.2023.40.3.1 Cognición en la esquizofrenia. Revisión sistemática resistant schizophrenia, Therefore, activities related to neurocognitive rehabilitation and psychosocial interventions as a complement to first-line pharmacotherapy seem to exert a protective role on cognition, contribute to the stabilization of negative and positive symptoms and increase the patient's functionality and well-being. It is advisable to strengthen neuropsychological research on schizophrenia and cognitive impairment in Latin America and to address cognitive impairment in schizophrenia from specific domains in subsequent studies.