New research from the Centre for Addiction and Mental Health (CAMH) shows a significant relationship between motivational deficit and poor cognitive performance in people with schizophrenia.
The study, published online in JAMA Psychiatry, is one of the first to link the two symptoms and suggests that understanding the impact of motivational impairment is an important step toward improving treatments for the disorder.
“Loss of motivation is a core feature of schizophrenia that we need to investigate with increased focus,” said Dr. Gary Remington, senior scientist with CAMH’s Campbell Family Mental Health Research Institute who served as the senior investigator on the study team. “It’s possible that the loss of motivation is linked to a brain abnormality
related to how people with the illness calculate effort. We’re starting to see how fundamental this loss of drive is and how much of a barrier it can be to treatment and to optimal functioning in daily life.”
Schizophrenia is a severe mental illness characterized by a diverse set of signs and symptoms including “positive,” “negative” and “cognitive” symptoms.
Positive symptoms include delusions, hallucinations, and other reality distortions known as psychosis. Negative symptoms include deficits in motivation and effort, and social withdrawal.
Cognitive impairments are more subtle and include trouble with attention, memory and planning ability.
Treatment options for schizophrenia are limited and existing medications treat only one symptom of the illness (psychosis).
Over the last decade, research efforts have shifted to focus on addressing cognitive symptoms but little attention has been paid to the interrelationship of symptoms and how motivational impairment itself can impact cognitive ability.
“We know that cognitive impairment can be devastating for people with schizophrenia and there is a push to look at solutions, including medication options, brain training and brain stimulation techniques,” said lead author Gagan Fervaha, a researcher in the Complex Mental Illness program at CAMH.
“But that might not be the whole picture. This study shows that we also need to look at motivational impairment and how it impacts cognition in order to target treatments in a better way.”
Fervaha said the research results demonstrate that motivation needs to be evaluated in any assessment of cognition for people with schizophrenia.
