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Why do they want cognitive testing?


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22 minutes ago, DogMan said:

I'm 42

 

MH care team want to do cognitive testing. Memory function and functional testing 

 

Unsure what it is about. If it is just standard practice for the clinic. Or if it is more specific 

Can you flat out ask them for a reason?

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Hello @DogMan

It is good to ask, I agree!

I see you have a diagnosis of schizoaffective disorder. I don't know how similar that is to the progression of schizophrenia. But I think it's a good idea to do the cognitive testing periodically in Schizophrenia, because this function can deteriorate, over time. It could be the same for Schizoaffective, but I don't know.

If you haven't been complaining of things like forgetfulness, maybe due to your age they just want to establish a baseline while you're still well. Then if you do experience cognitive dysfunction they can compare your decline to other people with your disorder, or in people without any disorder, to see which group you are most similar to.

Cognitive decline is a real quality of life issue for a lot of people with schizophrenia, I understand. 

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On 2/21/2022 at 1:26 PM, DogMan said:

I'm 42

 

MH care team want to do cognitive testing. Memory function and functional testing 

 

Unsure what it is about. If it is just standard practice for the clinic. Or if it is more specific 

I had cognitive testing done on me who was in a state hospital at one point. I’m not sure why either. My intelligence test came back as under normal. I’m not sure why. I sure feel dumb as a box of rocks though. I’m forgetful too. But I don’t know that I’d say I’m below average intelligence. Maybe. I don’t know. I’m 38 now, if that helps. 

On 2/21/2022 at 10:29 PM, undone said:

Hello @DogMan

It is good to ask, I agree!

I see you have a diagnosis of schizoaffective disorder. I don't know how similar that is to the progression of schizophrenia. But I think it's a good idea to do the cognitive testing periodically in Schizophrenia, because this function can deteriorate, over time. It could be the same for Schizoaffective, but I don't know.

If you haven't been complaining of things like forgetfulness, maybe due to your age they just want to establish a baseline while you're still well. Then if you do experience cognitive dysfunction they can compare your decline to other people with your disorder, or in people without any disorder, to see which group you are most similar to.

Cognitive decline is a real quality of life issue for a lot of people with schizophrenia, I understand. 

Can I ask what do you mean by cognitive decline in schizophrenia? And dysfunction? And quality of life issues? I’m worried about this. Thank you. 

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2 hours ago, Wonderful.Cheese said:

Can I ask what do you mean by cognitive decline in schizophrenia? And dysfunction? And quality of life issues? I’m worried about this. Thank you. 

Sure thing, @Wonderful.Cheese

Here's what I was trying to say!

Most everyone experiences some kind of cognitive decline, as we age. How fast the decline happens, and how much it affects your life varies from person to person. People with degenerative brain diseases like Alzheimer's or Schizophrenia might experience cognitive decline faster than someone who doesn't have those conditions. 

Dysfunction, or impairment just means that something in your cognition isn't functioning as would be expected for your age group, education level, or similar parameters. Doctors test things like your memory skills and thinking skills.

You can have cognitive impairment without being at a higher risk for cognitive decline. For example, a person who's intoxicated will experience a temporary cognitive impairment if it takes them longer to think through and answer your questions than it normally would, but that person is unlikely to experience rapid cognitive decline as they age, just from being intoxicated one time. A person with a head injury might have permanent cognitive impairment, like a loss of the memory of the head injury but they may not experience cognitive decline at a faster rate as they age. These aren't degenerative conditions, so cognitive decline might be normal for those people.

People experience quality of life issues due to cognitive impairment or decline when their memory and thinking skills are so poor that it interferes with their daily life. Most people have lost their keys here and there. That interferes with their life every once in a while, but it's nothing unusual, or too disruptive. A boss will understand If you lose your keys once or twice a year, and are late to work as a result. If you lose your keys every week, or every other day, and can't get to work, your boss likely won't be able to tolerate that, and will have to terminate you. That's a quality of life issue. Your inability to remember where your keys are changed your life, for the worse.

When you think of someone with Alzheimer's disease, you understand that the disease often affects them in milder ways, and then increases over time. Early on, frequently forgetting where your slippers are seems like a mild inconvenience, and not a quality of life issue. But as the disease progresses, and you can no longer remember your son's name, or you continue to pour salt in your coffee instead of sugar - then you're experiencing quality of life issues. It literally means that your life has been affected poorly.

You are surely not dumb as a box of rocks! I've seen some of your posts, and never once thought that of you! But if you feel like maybe you've experienced a decline in your memory or thinking since your last cognition test, you could tell your doctor what you've noticed, and ask to do a new one and compare it to the old one.

Not everyone with Schizophrenia experiences a more rapid cognitive decline. I would say probably everyone with Schizophrenia who is in an acute psychotic state probably would be described as experiencing cognitive impairment, though. It's very difficult to think things through as you normally would, when you're having hallucinations, for example. Like...if you're hearing voices that drown out half of what your doctor is saying, it may be almost impossible to answer appropriately. When the hallucinations fade away, your thinking can return to normal, in Schizophrenia. But thinking can slow and memory can worsen in Schizophrenia, even in the absence of things like hallucinations. There's some evidence that memory problems in particular are very common in Schizophrenia, and might even start before a person with Schizophrenia experiences their first episode of psychosis.

Here's articles about that:

Cognitive impairment in schizophrenia | Advances in Psychiatric Treatment | Cambridge Core

Long-Term Cognitive Decline Found in Schizophrenia and Other Psychoses - Psychiatry Advisor

I hope that helps some. Take care.

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