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Cognition and Treatment Resistance in Schizophrenia

Led by Philip Harvey. Posted on 9 Nov 2014

On November 10, 2014, SRF joined with the International Congress on Schizophrenia Research in the first of a series of webinars on major topics in psychosis research. Our discussion of cognition and treatment resistance was led by Philip Harvey of the University of Miami, who was joined by panelists Deanna Barch of Washington University, Jim Gold of the Maryland Psychiatric Research Center, and Richard Keefe of Duke University. We invite you to submit any comments on the discussion text, and any questions you would like the panelists to address.


Listen to the Webinar


Philip Harvey's Presentation


Deanna Barch's Presentation


James Gold's Presentation


Richard Keefe's Presentation


Background Text

by Philip Harvey

Traditionally, treatment resistance or nonresponse in schizophrenia was conceptualized entirely on the basis of psychotic symptoms. However, it is now widely understood that most treated patients with schizophrenia manifest substantial everyday disability, which is much more common than partial or complete failure for symptoms to respond to antipsychotic treatment. With optimal antipsychotic treatment, disability is related to other features of the illness, including cognitive impairments and negative symptoms, and minimally to the presence of psychosis. Thus, this webinar will address several topics, including the differential roles of neurocognitive deficits and social cognitive impairments for different domains of outcome, the role of cognition and related factors in adherence to treatment, and information about the developmental course of cognitive impairment in relation to relapse and the development of treatment resistance. Finally, the webinar will continue to advance the view that treatment of schizophrenia is not truly successful while disability in everyday functioning and social domains remains persistent.


Suggested reading:

Toward a terminology of functional recovery in schizophrenia: Is functional remission a viable concept? Philip D. Harvey & Alan S. Bellack. Schizophrenia Bulletin, 2009, 35, 300-306.

Cognition and motivation as treatment targets in schizophrenia. Keefe RS. JAMA Psychiatry. 2014 Sep;71(9):987-8. doi: 10.1001/jamapsychiatry.2014.1281.