Zusammenfassung
Es ist weithin bekannt, dass schizophrene Erkrankungen häufig mit Beeinträchtigungen der kognitiven Leistungsfähigkeit einhergehen. In neuerer Zeit haben insbesondere Defizite höherer Kontroll- und Steuerungsprozesse („exekutive Funktionen”) das Forschungsinteresse erregt, da sie die Fähigkeit der Patienten, unabhängig zu leben, nachhaltig beeinträchtigen können. Darüber hinaus wird versucht, der Heterogenität schizophrener Psychopathologie gerecht zu werden, indem voneinander abgrenzbare psychopathologische Syndrome und Veränderungen in einzelnen kognitiven Bereichen miteinander in Beziehung gesetzt werden. Die vorliegende Übersichtsarbeit unterzieht vor allem diejenigen Befunde einer eingehenden Betrachtung, die eine Assoziation zwischen schizophrener Negativsymptomatik und Beeinträchtigungen exekutiver Steuerungsprozesse herstellen. Aus neurobiologischer Sicht ergeben sich Hinweise darauf, dass biochemische, strukturelle und funktionelle Abweichungen im Frontalkortex und assoziierten fronto-subkortikalen Schleifen eine gemeinsame Basis der schizophrenen Negativsymptomatik und Störungen der exekutiven Handlungskontrolle bilden. Zahlreiche neuropsychologische Untersuchungen belegen eine Assoziation zwischen Negativsymptomatik und Defiziten in den kognitiven Bereichen Reaktionsinhibition, parallele Aufgabenbearbeitung, kognitive Flexibilität, Kontextaktualisierung, Problemlösen und Wortflüssigkeit. In manchen Fällen wird jedoch eher das Desorganisationssyndrom und nicht die Negativsymptomatik mit mangelhaften Leistungen in den genannten Bereichen in Verbindung gebracht. Die inkonsistenten Befunde werden teilweise auf eine unbefriedigende Abgrenzung der beiden Symptomkomplexe zurückgeführt.
Künftige Forschungsvorhaben sollten eine genauere Differenzierung zwischen primärer und sekundärer Negativsymptomatik in Betracht ziehen. Auch wäre sowohl eine möglichst spezifische als auch eine ökologisch valide Erfassung höherer Kontroll- und Steuerungsprozesse wünschenswert.
Abstract
It is widely recognized that schizophrenic disorders are often associated with impairments of cognitive performance. More recently, disorders of higher cognitive control processes (“executive control functions”) have captured the attention of researchers as they can considerably impair patients’ abilities to live an independent life. Apart from that, considering the heterogeneity of schizophrenia, there have been attempts to relate psychopathological syndromes to changes in distinct cognitive domains. The present review selectively focuses on evidence associating negative symptoms in schizophrenia with deficient performance in specific executive domains. Neurobiological evidence points to biochemical, structural and functional abnormities in the frontal cortex and associated fronto-subcortical circuits as a common basis of both schizophrenic negative symptoms and disorders of executive control. In a multitude of neuropsychological studies, an association between negative symptoms and problems in the domains of response inhibition, multitasking, cognitive flexibility, contextual updating, problem solving and verbal fluency has been reported. In some cases, however, the disorganization syndrome but not the negative syndrome has been linked with impaired behaviour in these domains. The inconsistencies might be partly due to the unsatisfactory differentiation between the two symptom complexes. Future research should furthermore consider a more precise differentiation between primary and secondary negative symptoms. Finally, the assessment of executive control functions should be both specific and ecologically valid.
Literatur
-
1
Jablensky A, Sartorius N, Ernberg G, Anker M, Korten A, Cooper J E, Day R, Bertelsen A.
Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study.
Psychol Med Monogr Suppl.
1992;
20
1-97
-
2
Knapp M, Mangalore R, Simon J.
The global costs of schizophrenia.
Schizophr Bull.
2004;
30
279-293
-
3 Kraepelin E. Dementia Praecox and Paraphrenia. Zinkin J (trans) New York: International Universities Press Inc 1950
-
4
Heinrichs R W, Zakzanis K K.
Neurocognitive deficit in schizophrenia: a quantitative review of the evidence.
Neuropsychology.
1998;
12
426-445
-
5
Snitz B, Daum I.
The Neuropsychology of Schizophrenia: A Selective Review.
Z Neuropsychologie.
2001;
12 (1)
3-7
-
6
Green M F.
What are the functional consequences of neurocognitive deficits in schizophrenia?.
Am J Psychiatry.
1996;
153
321-330
-
7
Simon A E, Giacomini V, Ferrero F, Mohr S.
Dysexecutive syndrome and social adjustment in schizophrenia.
Aust N Z J Psychiatry.
2003;
37
340-346
-
8 Luria A R. Higher cognitive functions in man. New York: Basic Books 1980
-
9 Lezak M D. Neuropsychological Assessment. New York: NY Oxford 1995
-
10
Crow T J.
Positive and negative schizophrenic symptoms and the role of dopamine.
Br J Psychiatry.
1980;
137
383-386
-
11
Liddle P F.
The symptoms of chronic schizophrenia. A re-examination of the positive-negative dichotomy.
Br J Psychiatry.
1987;
151
145-151
-
12
Andreasen N C.
Symptoms, signs, and diagnosis of schizophrenia.
Lancet.
1995;
346
477-481
-
13
Carpenter Jr W T, Arango C, Buchanan R W, Kirkpatrick B.
Deficit psychopathology and a paradigm shift in schizophrenia research.
Biol Psychiatry.
1999;
46
352-360
-
14
Donohoe G, Robertson I H.
Can specific deficits in executive functioning explain the negative symptoms of schizophrenia? A review.
Neurocase.
2003;
9
97-108
-
15
Tandon R, DeQuardo J R, Taylor S F, McGrath M, Jibson M, Eiser A, Goldman M.
Phasic and enduring negative symptoms in schizophrenia: biological markers and relationship to outcome.
Schizophr Res.
2000;
45
191-201
-
16
Tamminga C A, Buchanan R W, Gold J M.
The role of negative symptoms and cognitive dysfunction in schizophrenia outcome.
Int Clin Psychopharmacol.
1998;
13 Suppl 3
21-26
-
17 Hughlings-Jackson J. Selected Writings. Taylor J (Hrsg). London: Hodder and Stoughton Ltd 1931
-
18
Brown R G, Pluck G.
Negative symptoms: the "pathology" of motivation and goal-directed behaviour.
Trends Neurosci.
2000;
23
412-417
-
19
Frith C D, Done D J.
Towards a neuropsychology of schizophrenia.
Br J Psychiatry.
1988;
153
437-443
-
20
Carpenter Jr W T, Heinrichs D W, Wagman A M.
Deficit and nondeficit forms of schizophrenia: the concept.
Am J Psychiatry.
1988;
145
578-583
-
21
Kirkpatrick B, Buchanan R W, McKenney P D, Alphs L D, Carpenter Jr W T.
The Schedule for the Deficit syndrome: an instrument for research in schizophrenia.
Psychiatry Res.
1989;
30
119-123
-
22
Arango C, Buchanan R W, Kirkpatrick B, Carpenter Jr W T.
The deficit syndrome in schizophrenia: implications for the treatment of negative symptoms.
Eur Psychiatry.
2004;
19
21-26
-
23
Buchanan R W, Gold J M.
Negative symptoms: diagnosis, treatment and prognosis.
Int Clin Psychopharmacol.
1996;
11 Suppl 2
3-11
-
24
Addington J, Addington D.
Premorbid functioning, cognitive functioning, symptoms and outcome in schizophrenia.
J Psychiatry Neurosci.
1993;
18
18-23
-
25
Agerbo E, Byrne M, Eaton W W, Mortensen P B.
Marital and labor market status in the long run in schizophrenia.
Arch Gen Psychiatry.
2004;
61
28-33
-
26
Arango C, Adami H, Sherr J D, Thaker G K, Carpenter Jr W T.
Relationship of awareness of dyskinesia in schizophrenia to insight into mental illness.
Am J Psychiatry.
1999;
156
1097-1099
-
27
Kirkpatrick B, Buchanan R W, Breier A, Carpenter Jr W T.
Depressive symptoms and the deficit syndrome of schizophrenia.
J Nerv Ment Dis.
1994;
182
452-455
-
28
Fenton W S, McGlashan T H, Victor B J, Blyler C R.
Symptoms, subtype, and suicidality in patients with schizophrenia spectrum disorders.
Am J Psychiatry.
1997;
154
199-204
-
29
Kirkpatrick B, Amador X F, Flaum M, Yale S A, Gorman J M, Carpenter Jr W T, Tohen M, McGlashan T.
The deficit syndrome in the DSM-IV Field Trial: I. Alcohol and other drug abuse.
Schizophr Res.
1996;
20
69-77
-
30
Lewine R R.
Sex differences in schizophrenia: timing or subtypes?.
Psychol Bull.
1981;
90
432-434
-
31
Ring N, Tantam D, Montague L, Newby D, Black D, Morris J.
Gender differences in the incidence of definite schizophrenia and atypical psychosis - focus on negative symptoms of schizophrenia.
Acta Psychiatr Scand.
1991;
84
489-496
-
32
Scully P J, Coakley G, Kinsella A, Waddington J L.
Psychopathology, executive (frontal) and general cognitive impairment in relation to duration of initially untreated versus subsequently treated psychosis in chronic schizophrenia.
Psychol Med.
1997;
27
1303-1310
-
33
Arango C, Kirkpatrick B, Buchanan R W.
Neurological signs and the heterogeneity of schizophrenia.
Am J Psychiatry.
2000;
157
560-565
-
34
Overall J E, Gorham D R.
The Brief Psychiatric Rating Scale (BPRS): recent developments in ascertainment and scaling.
Psychopharmacol Bull.
1988;
24
97-99
-
35 Berman K F, Weinberger D R. Prefrontal dopamine and defect symptoms in schizophrenia. In: Greden JF, Tandon R (Hrsg). Negative schizophrenic symptoms: Psychophysiology and clinical implications. Washington DC: American Psychiatric Press 1991: 81-95
-
36
Davis K L, Kahn R S, Ko G, Davidson M.
Dopamine in schizophrenia: a review and reconceptualization.
Am J Psychiatry.
1991;
148
1474-1486
-
37
Goff D C, Coyle J T.
The emerging role of glutamate in the pathophysiology and treatment of schizophrenia.
Am J Psychiatry.
2001;
158
1367-1377
-
38
Tandon R, Greden J F.
Cholinergic hyperactivity and negative schizophrenic symptoms. A model of cholinergic/dopaminergic interactions in schizophrenia.
Arch Gen Psychiatry.
1989;
46
745-753
-
39
Goff D C, Evins A E.
Negative symptoms in schizophrenia: neurobiological models and treatment response.
Harv Rev Psychiatry.
1998;
6
59-77
-
40
Lieberman J A, Sheitman B B, Kinon B J.
Neurochemical sensitization in the pathophysiology of schizophrenia: deficits and dysfunction in neuronal regulation and plasticity.
Neuropsychopharmacology.
1997;
17
205-229
-
41 Weinberger D R, Wyatt R J. Brain morphology in schizophrenia: In vivo studies. In: Henn FA, Nasrallah HA (Hrsg). Schizophrenia as a Brain Disease. New York: Oxford University Press 1982
-
42
Andreasen N C, Flaum M, Swayze V W, Tyrrell G, Arndt S.
Positive and negative symptoms in schizophrenia. A critical reappraisal.
Arch Gen Psychiatry.
1990;
47
615-621
-
43
d'Amato T, Rochet T, Dalery J, Laurent A, Chauchat J H, Terra J L, Marie-Cardine M.
Relationship between symptoms rated with the Positive and Negative Syndrome Scale and brain measures in schizophrenia.
Psychiatry Res.
1992;
44
55-62
-
44
Johnstone E C, Crow T J, Frith C D, Husband J, Kreel L.
Cerebral ventricular size and cognitive impairment in chronic schizophrenia.
Lancet.
1976;
2
924-926
-
45 Borgerts B. Bedeutung des Frontalhirns für die Pathophysiologie schizophrener Erkrankungen. In: Förstl H (Hrsg). Frontalhirn: Funktionen und Erkrankungen. Berlin, Heidelberg: Springer 2002: 181-205
-
46
Sanfilipo M, Lafargue T, Rusinek H, Arena L, Loneragan C, Lautin A, Rotrosen J, Wolkin A.
Cognitive performance in schizophrenia: relationship to regional brain volumes and psychiatric symptoms.
Psychiatry Res.
2002;
116
1-23
-
47
Coger R W, Serafetinides E A.
Schizophrenia, corpus callosum, and interhemispheric communication: a review.
Psychiatry Res.
1990;
34
163-184
-
48 Kandel E R. Disorders of Thought and Volition: Schizophrenia. In: Kandel ER, Schwartz JH, Jessell TM (Hrsg). Principles of Neural Science. 4th International Edition. New York: McGraw Hill 2000: 1188-1207
-
49
Goethals I, Audenaert K, Van de Wiele C, Dierckx R.
The prefrontal cortex: insights from functional neuroimaging using cognitive activation tasks.
Eur J Nucl Med Mol Imaging.
2004;
31
408-416
-
50
Royall D R, Lauterbach E C, Cummings J L, Reeve A, Rummans T A, Kaufer D I, LaFrance Jr W C, Coffey C E.
Executive control function: a review of its promise and challenges for clinical research. A report from the Committee on Research of the American Neuropsychiatric Association.
J Neuropsychiatry Clin Neurosci.
2002;
14
377-405
-
51
Alexander G E, Crutcher M D, DeLong M R.
Basal ganglia-thalamocortical circuits: parallel substrates for motor, oculomotor, “prefrontal” and “limbic” functions.
Prog Brain Res.
1990;
85
119-146
-
52
Velligan D I, Bow-Thomas C C.
Executive function in schizophrenia.
Semin Clin Neuropsychiatry.
1999;
4
24-33
-
53
Hutton S B, Puri B K, Duncan L J, Robbins T W, Barnes T R, Joyce E M.
Executive function in first-episode schizophrenia.
Psychol Med.
1998;
28
463-473
-
54
Trestman R L, Keefe R S, Mitropoulou V, Harvey P D, deVegvar M L, Lees-Roitman S, Davidson M, Aronson A, Silverman J, Siever L J.
Cognitive function and biological correlates of cognitive performance in schizotypal personality disorder.
Psychiatry Res.
1995;
59
127-136
-
55
Goldberg T E, Torrey E F, Gold J M, Bigelow L B, Ragland R D, Taylor E, Weinberger D R.
Genetic risk of neuropsychological impairment in schizophrenia: a study of monozygotic twins discordant and concordant for the disorder.
Schizophr Res.
1995;
17
77-84
-
56
Gambini O, Campana A, Garghentini G, Scarone S.
No evidence of a homogeneous frontal neuropsychological profile in a sample of schizophrenic subjects.
J Neuropsychiatry Clin Neurosci.
2003;
15
53-57
-
57
Evans J J, Chua S E, McKenna P J, Wilson B A.
Assessment of the dysexecutive syndrome in schizophrenia.
Psychol Med.
1997;
27
635-646
-
58
Buchanan R W, Strauss M E, Kirkpatrick B, Holstein C, Breier A, Carpenter Jr W T.
Neuropsychological impairments in deficit vs nondeficit forms of schizophrenia.
Arch Gen Psychiatry.
1994;
51
804-811
-
59
Wagman A M, Heinrichs D W, Carpenter Jr W T.
Deficit and nondeficit forms of schizophrenia: neuropsychological evaluation.
Psychiatry Res.
1987;
22
319-330
-
60
Baxter R D, Liddle P F.
Neuropsychological deficits associated with schizophrenic syndromes.
Schizophr Res.
1998;
30
239-249
-
61
Brazo P, Marie R M, Halbecq I, Benali K, Segard L, Delamillieure P, Langlois-Thery S, Van der Elst A, Thibaut F, Petit M, Dollfus S.
Cognitive patterns in subtypes of schizophrenia.
Eur Psychiatry.
2002;
17
155-162
-
62
Woodward T S, Ruff C C, Thornton A E, Moritz S, Liddle P F.
Methodological considerations regarding the association of Stroop and verbal fluency performance with the symptoms of schizophrenia.
Schizophr Res.
2003;
61
207-214
-
63
Hepp H H, Maier S, Hermle L, Spitzer M.
The Stroop effect in schizophrenic patients.
Schizophr Res.
1996;
22 (3)
187-195
-
64
Perlstein W M, Carter C S, Barch D M, Baird J W.
The Stroop task and attention deficits in schizophrenia: a critical evaluation of card and single-trial Stroop methodologies.
Neuropsychology.
1998;
12
414-425
-
65
Waters F A, Badcock J C, Maybery M T, Michie P T.
Inhibition in schizophrenia: Association with auditory hallucinations.
Schizophr Res.
2003;
62 (3)
275-280
-
66
Kay S R, Fiszbein A, Opler L A.
The positive and negative syndrome scale (PANSS) for schizophrenia.
Schizophr Bull.
1987;
13
261-276
-
67
Burgess P W, Shallice T.
Response suppression, initiation and strategy use following frontal lobe lesions.
Neuropsychologia.
1995;
34 (4)
263-272
-
68
Gale H J, Holzman P S.
A new look at reaction time in schizophrenia.
Schizophr Res.
2000;
46
149-165
-
69
Reuter B, Kathmann N.
Using saccade tasks as a tool to analyze executive dysfunctions in schizophrenia.
Acta Psychol (Amst).
2004;
115
255-269
-
70
Muller N, Riedel M, Eggert T, Straube A.
Internally and externally guided voluntary saccades in unmedicated and medicated schizophrenic patients. Part II. Saccadic latency, gain, and fixation suppression errors.
Eur Arch Psychiatry Clin Neurosci.
1999;
249
7-14
-
71
Tien A Y, Ross D E, Pearlson G, Strauss M E.
Eye movements and psychopathology in schizophrenia and bipolar disorder.
J Nerv Ment Dis.
1996;
184
331-338
-
72
McDowell J E, Brown G G, Paulus M, Martinez A, Stewart S E, Dubowitz D J, Braff D L.
Neural correlates of refixation saccades and antisaccades in normal and schizophrenia subjects.
Biol Psychiatry.
2002;
51
216-223
-
73
Heyder K, Suchan B, Daum I.
Cortico-subcortical contributions to executive control.
Acta Psychol (Amst).
2004;
115
271-289
-
74
Burgess P W, Veitch E, de Lacy C A, Shallice T.
The cognitive and neuroanatomical correlates of multitasking.
Neuropsychologia.
2000;
38
848-863
-
75
Granholm E, Asarnow R F, Marder S R.
Controlled information processing resources and the development of automatic detection responses in schizophrenia.
J Abnorm Psychol.
1991;
100
22-30
-
76
Schwartz F, Munich R L, Carr A, Bartuch E, Lesser B, Rescigno D, Viegener B.
Negative symptoms and reaction time in schizophrenia.
J Psychiatr Res.
1991;
25
131-140
-
77
Fuller R, Jahanshahi M.
Concurrent performance of motor tasks and processing capacity in patients with schizophrenia.
J Neurol Neurosurg Psychiatry.
1999;
66
668-671
-
78
Cameron A M, Oram J, Geffen G M, Kavanagh D J, McGrath J J, Geffen L B.
Working memory correlates of three symptom clusters in schizophrenia.
Psychiatry Res.
2002;
110
49-61
-
79 Reitan R M. Trail Making-Test (Adult Version). USA: Reitan Neuropsychology Laboratory 1992
-
80
Mahurin R K, Velligan D I, Miller A L.
Executive-frontal lobe cognitive dysfunction in schizophrenia: a symptom subtype analysis.
Psychiatry Res.
1998;
79
139-149
-
81
Allen D N, Anastasiou A, Goldstein G, Gilbertson M, van Kammen D P.
Influence of haloperidol on the relationship of frontal lobe function to psychomotor poverty and disorganization syndromes.
Psychiatry Res.
2000;
93
33-39
-
82
O"Leary D S, Flaum M, Kesler M L, Flashman L A, Arndt S, Andreasen N C.
Cognitive correlates of the negative, disorganized, and psychotic symptom dimensions of schizophrenia.
J Neuropsychiatry Clin Neurosci.
2000;
12
4-15
-
83
Pantelis C, Harvey C A, Plant G, Fossey E, Maruff P, Stuart G W, Brewer W J, Nelson H E, Robbins T W, Barnes T R.
Relationship of behavioural and symptomatic syndromes in schizophrenia to spatial working memory and attentional set-shifting ability.
Psychol Med.
2004;
34
693-703
-
84
Nieuwenstein M R, Aleman A, de Haan E H.
Relationship between symptom dimensions and neurocognitive functioning in schizophrenia: a meta-analysis of WCST and CPT studies. Wisconsin Card Sorting-Test. Continuous Performance-Test.
J Psychiatr Res.
2001;
35
119-125
-
85
Milner B.
Effects of brain lesions on card sorting.
Arch Neurol.
1963;
9
90-100
-
86
Liu Z, Tam W C, Xie Y, Zhao J.
The relationship between regional cerebral blood flow and the Wisconsin Card Sorting-Test in negative schizophrenia.
Psychiatry Clin Neurosci.
2002;
56
3-7
-
87
Braver T S, Barch D M, Cohen J D.
Cognition and control in schizophrenia: a computational model of dopamine and prefrontal function.
Biol Psychiatry.
1999;
46
312-328
-
88 Thoma P, Zoppelt D, Wiebel B, Daum I. Context processing and negative symptoms in schizophrenia. (Manuskript eingereicht)
-
89
Cohen J D, Barch D M, Carter C, Servan-Schreiber D.
Context-processing deficits in schizophrenia: converging evidence from three theoretically motivated cognitive tasks.
J Abnorm Psychol.
1999;
108
120-133
-
90
Kerns J G, Berenbaum H.
The relationship between formal thought disorder and executive functioning component processes.
J Abnorm Psychol.
2003;
112
339-352
-
91
Docherty N M, DeRosa M, Andreasen N C.
Communication disturbances in schizophrenia and mania.
Arch Gen Psychiatry.
1996;
53
358-364
-
92
Menon V, Anagnoson R T, Mathalon D H, Glover G H, Pfefferbaum A.
Functional neuroanatomy of auditory working memory in schizophrenia: relation to positive and negative symptoms.
Neuroimage.
2001;
13
433-446
-
93
Perlstein W M, Carter C S, Noll D C, Cohen J D.
Relation of prefrontal cortex dysfunction to working memory and symptoms in schizophrenia.
Am J Psychiatry.
2001;
158
1105-1113
-
94
Shallice T.
Specific impairments of planning.
Philos Trans R Soc Lond B Biol Sci.
1982;
298 (1089)
199-209
-
95
Andreasen N C, Rezai K, Alliger R, Swayze V W, Flaum M, Kirchner P, Cohen G, O'Leary D S.
Hypofrontality in neuroleptic-naive patients and in patients with chronic schizophrenia. Assessment with xenon 133 single-photon emission computed tomography and the Tower of London.
Arch Gen Psychiatry.
1992;
49
943-958
-
96 Andreasen N C. Scale for the Assessment of Negative Symptoms (SANS). Iowa City: The University of Iowa 1983
-
97
Ludewig K, Paulus M P, Vollenweider F X.
Behavioural dysregulation of decision-making in deficit but not nondeficit schizophrenia patients.
Psychiatry Res.
2003;
119
293-306
-
98
Paulus M P, Hozack N E, Zauscher B E, Frank L, Brown G G, McDowell J, Braff D L.
Parietal dysfunction is associated with increased outcome-related decision-making in schizophrenia patients.
Biol Psychiatry.
2002;
51
995-1004
-
99
Andres P.
Frontal cortex as the central executive of working memory: time to revise our view.
Cortex.
2003;
39
871-895
-
100
Ready R E, Stierman L, Paulsen J S.
Ecological validity of neuropsychological and personality measures of executive functions.
Clin Neuropsychol.
2001;
15 (3)
314 -323
-
101
Semkovska M, Stip E, Godbout L, Paquet F, Bedard M A.
Behavioral disorganization in schizophrenia during a daily activity: the kitchen behavioral scoring scale.
Brain Cogn.
2002;
48
546-553
-
102 Liddle P F. Syndromes in schizophrenia and their neuropsychological and neuroanatomical correlates. In: Pantelis C, Nelson HE, Barnes TRE (Hrsg). Schizophrenia: A neuropsychological Perspective. Chichester: John Wiley 1996
-
103
Schatz J.
Cognitive processing efficiency in schizophrenia: generalized vs domain specific deficits.
Schizophr Res.
1998;
30
41-49
-
104 Andreasen N C. Scale for the Assessment of Positive Symptoms (SAPS). Iowa City: The University of Iowa 1984
-
105
Kasper S, Resinger E.
Cognitive effects and antipsychotic treatment.
Psychoneuroendocrinology.
2003;
28 Suppl 1
27-38
-
106
Medalia A, Revheim N, Casey M.
Remediation of problem-solving skills in schizophrenia: evidence of a persistent effect.
Schizophr Res.
2002;
57
165-171
-
107
Bellucci D M, Glaberman K, Haslam N.
Computer-assisted cognitive rehabilitation reduces negative symptoms in the severely mentally ill.
Schizophr Res.
2003;
59
225-232
Dipl.-Psych. Patrizia Thoma
Institut für Kognitive Neurowissenschaft, Abteilung Neuropsychologie · Ruhr-Universität Bochum
Universitätsstraße 150
44801 Bochum
eMail: Patrizia.Thoma@rub.de
