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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0018

Cognitive decline in schizophrenia: Its impact on social functioning and opportunities for cognitive remediation

COGNITIVE DECLINE IN SCHIZOPHRENIA: ASSESSING ITS IMPACT ON SOCIAL FUNCTIONING AND PROSPECTS FOR COGNITIVE REMEDIATION

Cognitive impairment in schizophrenia predicts long-term disability more reliably than psychotic symptoms, yet cognitive remediation remains underused despite its proven effectiveness.

The aim of this review is to synthesize evidence on the course and neurobiology of cognitive decline in schizophrenia, its relationship with everyday social functioning, and cognitive remediation as a targeted nonpharmacological treatment. The method is a narrative review of peer-reviewed literature published between 2018 and 2024, encompassing meta-analyses, randomized trials, and longitudinal cohorts, along with EPA guidance and international expert consensus. Cognitive impairment is a largely treatment-resistant core feature affecting up to 80% of patients; deficits in processing speed, verbal memory, attention, working memory, and executive functioning can be detected before the first psychotic episode and persist throughout the illness. These deficits predict long-term disability more reliably than psychotic symptoms; social and occupational functioning depend on executive functioning and working memory rather than symptom severity. Routine pharmacological treatment leaves this domain largely unaddressed; a 2024 meta-analysis shows that gains achieved through cognitive remediation are sustained over the long term, and the EPA assigns this intervention its highest evidence grade. It can be delivered individually or in groups, with the greatest gains achieved when combined with supported employment. In conclusion, cognitive remediation is effective but underused; it should be part of routine psychiatric rehabilitation, with priorities including earlier initiation and tailoring to each patient's cognitive profile.

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