Influence of cognitive reserve in schizophrenia: A systematic review

Objective: To perform a systematic review of the influence of sociobehavioural indicators of cognitive reserve (CR) in the risk of schizophrenia, the clinical manifestations of the disease, and cognitive intervention programs (CRT) carried out with these patients. Method: A cross search was made by two independent reviewers in Pubmed and PsycINFO databases using keywords “schizophrenia” and “cognitive reserve.” Twenty-one studies which analyzed different CR proxies were selected and the level of evidence was classified according to the Oxford Centre for Evidence-Based Medicine. Result: People with higher CR may have a lower risk of developing schizophrenia and a later onset of disease. In addition, they present better neuropsychological and functional performance in the illness course. However, the suspected influence of CR on the effectiveness of CRT in patients with schizophrenia is currently unresolved. Conclusion: Our findings suggest that higher CR delays the clinical diagnosis threshold and severity of the symptoms in patients with schizophrenia. However, effect of singular sociobehavioral measures on clinical expression and benefits of intervention program need further investigation