How Schizophrenia Affects Cognition


Gina Garippo

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In many ways, people with schizophrenia are just like everyone else. But if their illness remains untreated, it can have a tremendous impact on their lives.

Some effects of schizophrenia, such as unusual behavior, are easy to see. What may be less obvious is how the illness affects the ability to think and reason. These are called cognitive symptoms. If you have a loved one with schizophrenia, you can help them by better understanding how they think and view the world.

How Cognitive Issues Impact Daily Life

People with schizophrenia often struggle with a number of cognitive symptoms. They may have unusual or dysfunctional ways of thinking. For example, some people with schizophrenia have poor “executive functioning.” That means they have difficulty understanding information and using it to make decisions. Others suffer from memory problems or have trouble paying attention, organizing their thoughts, or prioritizing tasks.

These cognitive problems can affect many areas of life. It might be difficult for your loved one to hold down a job or communicate well with family members. Cognitive problems can also interfere with the ability to perform even basic daily activities. For instance, they can make it difficult to remember to take medications or show up for appointments.

Lack of Insight and Awareness

One cognitive symptom common among people with schizophrenia is a lack of insight into their illness, also called anosognosia. People with anosognosia aren’t aware they have an illness or don’t understand how serious it is. This lack of insight can get in the way of living a productive life with schizophrenia. If a person isn’t aware that he or she has an illness, the person is much more apt to resist help, as well as not take medication or attend therapy.

Although it can be frustrating when your loved one doesn’t recognize his or her illness and resists treatment because of it, keep in mind that it isn’t the person’s fault. These cognitive issues stem from problems in the brain. Lack of awareness is not a choice, and it doesn’t mean the person is in willful denial. Ask your loved one’s doctor for resources to help you understand and overcome challenges related to this problem.

Improving Cognitive Function


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If your doctor has prescribed psychosocial therapy, make sure you participate.

Just as your loved one’s antipsychotic medication is essential in controlling symptoms like hallucinations and delusions, it can also help improve cognitive function. These medications are thought to work by correcting an imbalance of chemicals in the brain. Make sure you work with your loved one’s doctor to find a treatment plan that fits his or her needs.

In addition to medication, therapy can make a difference. Cognitive behavioral therapy (CBT) has been shown to help people with schizophrenia improve cognitive symptoms. The treatment involves talk therapy with the patient. The therapist works directly with him or her to develop ways to cope with—and overcome—symptoms. In addition, cognitive remediation treatment has been shown to improve cognitive functioning in people with schizophrenia. This treatment involves training in computer tasks and helping the brain function more efficiently.
Although treatment may not completely cure your loved one of cognitive problems, it can help improve them. Keep in mind that these issues are real symptoms of the illness. Continue to be patient with your loved one. And talk with your loved one’s doctor about how you can be the best support possible.

Key Takeaways:

  • People with schizophrenia often struggle with unusual or dysfunctional ways of thinking, memory problems, or trouble paying attention.

  • Cognitive problems can interfere with holding down a job, communicating with others, or even performing basic activities such as taking medication.

  • One common cognitive symptom is a lack of insight into the illness, also called anosognosia. People with anosognosia aren’t aware they have an illness or don’t understand how serious it is.

  • In addition to medication, cognitive behavioral therapy can help improve cognitive function.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Apr 11, 2016

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View Sources

Medical References

Anosognosia (Lack of Insight) Fact Sheet, National Alliance on Mental Health, Accessed Feb. 1, 2014.
Schizophrenia, National Alliance on Mental Health, Accessed Feb. 1, 2014.
Schizophrenia, National Institutes of Mental Health, Accessed Feb. 1, 2014.

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