Autistic people, whom we, due to our own cretinism, take for idiots, are in reality capable of doing things beyond our control.

On the scale of intelligence, you and I are much closer to garbage cats, wild cats, than to the average owners of savant syndrome. After all, an ordinary savant will multiply six-digit numbers in his head and quote the entire book he read ten years ago.

He will remember what happened to him on any day of his life and in a few days he will master a foreign language perfectly.

True, he will surprise you with his abilities with his fly unzipped, dried food on his chin and holding his mother’s hand.

Savantism was first described by John Langdon Down - the same Down who described the disease "Mongolism", later renamed Down syndrome *. In 1887, he introduced the expression idiot savant (“idiot scientist”; from the French savoir - to know), but neither this nor the term autistic savant (“autistic savant”), proposed by Bernard Rimland, is correct. The fact is that savantism is not a separate disease, it is just a symptom that can be caused by a variety of brain problems, ranging from physical trauma to dementia.
Funtik

*- Note:
“Don’t repeat Down’s mistakes: if you want to glorify your family name, first think carefully about how it might end.”

Kim Peek

If it weren't for Kim, Barry Morrow wouldn't have been inspired to write Rain Man and Dustin Hoffman wouldn't have won his Oscar. It was Kim, with his fantastic abilities, who became the prototype of Raymond the Rainman.

Kim was born in 1951, and from the first second of his existence it became clear that the child had big problems. His head was twice as large as that of an ordinary baby, in addition, on the back of his head it was also decorated with a cranial hernia the size of a baseball. The inside was no better than the outside: Kim was completely missing important parts of the brain such as the corpus callosum and the commissures that normally connect the left and right hemispheres. And the cerebellum, which is responsible for some motor functions, was smaller than usual and deformed. But instead of leading the quiet life of a docile plant, which the fairies of fate seemed to have prepared for him, Kim became a genius, whom his family and friends teased as Kimputer. Already at the age of one and a half years, Kim memorized the books that were read to him word for word. He went to the Salt Lake City City Library every day and knew about 9,000 works by heart. He devoured a page in 7–10 seconds, reading the right half of the spread with his right eye and the left half with his left. Kim's brain contained everything known to mankind regarding 15 topics of interest to him, including world and American history, sports, cinema, geography, space exploration, the Bible, church history, literature and classical music. One day, for some reason, he read the state telephone directory and memorized the numbers of all its inhabitants. If Kim had been given a car license, he would not have needed to spend money on a navigator, since he remembered in detail the maps of all American cities. But he was not destined to see the rights as his own brain hernia, because, despite all his genius, Kim was completely hopeless in terms of independent existence. His coordination of movements was monstrous, it was difficult for him to control his limbs, he walked like a puppet controlled by a drunken puppeteer. He moved through the streets only accompanied by his father, who dedicated his life to his son - he fed Kim, dressed him and tied his shoelaces.

Moreover, the intellectual genius was hopelessly bad at abstract concepts. For example, if they asked what it meant “he followed in his father’s footsteps,” Kim, after thinking, answered: “He held his hand so as not to get lost at the airport.”

Stephen Wiltshire

Little Stephen was not a talkative boy. Moreover, he never said anything at all. If he needed to sleep, he drew a bed; if you wanted milk, you drew a package. At the Queensmill School in London, where his parents sent a five-year-old autistic child, he could sit silently at the table for hours and draw a pencil in a sketchbook. But the sadistic teachers figured out how to make the child talk. They took his drawings and pretended that they didn’t understand what he was asking: “Do you want to draw, Stephen? Then say you need paper and pencils.” It worked once. Stephen extended his hands to his tormentors and with an effort, but clearly uttered his first words - “paper” and “pencil”. By the age of nine, he fully mastered speech and soon became the subject of the program The Foolish Wise Ones, in which he spoke about his ability to sketch any building just by glancing at it.

The audience and TV presenters doubted it, so the BBC decided to conduct an experiment. In a helicopter, accompanied by two reporters, Stephen rose above London and looked at the city from above for several minutes, after which, returning to the studio, he drew an accurate map of the area of ​​​​four square miles, on which he depicted about two hundred buildings in great detail. The card turned out to be so beautiful that Stephen immediately received requests from people who wanted to purchase it.

going to Manhattan from Steven's flight height

This is how the savant painter found his life’s work. Now he has already flown over Rome, Hong Kong, Jerusalem, Madrid, Tokyo and Dubai and recreated these cities on ten-meter canvases. Exhibitions of paintings by the 35-year-old Englishman are held all over the world, and in 2006, Queen Elizabeth II awarded Stephen the Order of the British Empire in recognition of his creative achievements.

Panorama of Tokyo

You'll spend more time taking in this Tokyo skyline than Stephen spent memorizing it.

Leslie Lemke

Leslie was a long-awaited child. His parents dreamed that they would have a beautiful, cheerful and healthy baby. And so they were horrified when they saw their son - a crooked creature with a damaged brain and cerebral palsy. In addition, Leslie turned out to have a severe form of glaucoma, so doctors had to amputate the child’s eyes in the first days of his life. Let's not blame Leslie's parents, who immediately formalized the renunciation of parental rights: every person has a limit on the load that he can bear. But nurse May Lemke, who was caring for Leslie, turned out to be a heavyweight in terms of everyday burdens and officially adopted the baby, thus acquiring a sixth child in addition to her own five. Having somehow learned to eat, talk and move independently, for a long time Leslie did nothing but sit silently for hours, listening to sounds and other people's conversations, and then repeating them with precise intonation. One day he heard a recording of Tchaikovsky's Concerto No. 1 on TV. After listening to the music, Leslie went to the old piano in the living room and played it the first time.

When the daughter sat down at the piano, the whole family gathered around and glued on her beard.

Since then, Leslie - blind, mentally retarded, with cerebral palsy, who has not had a single music lesson - can repeat any melody he heard at least once. Albeit without the artistry and depth characteristic of real performers, but without a single blemish, which easily happens to them.

Ellen Boudreau

Ellen is one of the few female savants. Blind, with mental retardation, she, like Leslie Lemke, hearing a melody for the first time, can immediately play it on the piano or guitar, although usually with errors and distortions. But Ellen has a unique talent, which has not yet been recorded in any savant or in any person at all: she uses echolocation no worse than whales and bats. Her parents were the first to notice her abilities, shocked by the fact that the four-year-old blind girl perfectly navigates space: she doesn’t touch doorframes, walks around chairs and easily runs down the stairs. True, all the time he mutters some strange song or muttering under his breath. It turns out that by the way sound travels, Ellen learns about objects in its path. So she can't get lost. And not only in space, but also in time. When the girl was five years old, she became interested in a stopwatch. They explained to her what it was, she listened to the ticking for a few seconds, and since then she can tell, down to the second, what time it is at a given moment.

Daniel Tammet

If you begin to experience severe epileptic seizures, do not rush to see a doctor right away. Wait a little: what if you develop memory and mathematical abilities, as happened with Daniel, the only savant who can explain the work of his brain (the rest usually cannot understand what they want to hear from them)? In the first years of his life, Daniel grew up as an ordinary child, but I don’t understand where the epilepsy came from and led to autism, serious problems in terms of communicating with other people and mathematical genius. A 30-year-old Englishman says that when he wants to solve a mathematical problem, he sees two vague geometric figures. Gradually the contours become more and more clear, and finally a third figure appears - the answer. Each number has its own color and shape for him, and he is able to draw or sculpt them. “In my perception, the nines are huge and blue, and I am still surprised that in the newspapers they are small and dark. Sixes look like tiny black holes to me. When I think about the number 89, something like snowflakes flies in front of me. But the number 351 resembles a spoonful of oatmeal.” The most beautiful and harmonious number for him is pi. Daniel can quote it to 22,514 decimal places. He demonstrated this ability on March 14, 2004, International Pi Day, setting a world record.

In addition, Daniel has amazing linguistic abilities. He knows 11 languages: English, French, Finnish, German, Spanish, Romanian, Lithuanian, Estonian, Welsh, Esperanto and Icelandic, which he learned in seven days after participating in an experiment in the documentary The brain man. Daniel is currently working on creating his own language - mänti. He teaches languages ​​online, does everything to the clock (any violation of the schedule throws him into panic and can cause a severe epileptic seizure) and lives with his friend Jerome. So now decide whether you need phenomenal memory and mathematical abilities.

How to catch savantism

Scientists can still only guess about the reasons causing savantism. Professor Nancy Minshew of the University of Pittsburgh, who has devoted her life to this problem, argues that abnormally high levels of testosterone (the masculinity hormone) in newborn savants cause increased brain growth and at the same time suppress the production of the hormone oxytocin, which is responsible for successful socialization. Neuroscientists from Vanderbilt University in Nashville believe that there are several dozen genes on the male X chromosome that are responsible for the birth of a savant child (this may explain the fact that there are five times more male savants than female savants). Professor Edwin Cook of the University of Chicago suggests the existence of a virus that causes mutations in brain neurons. Be that as it may, the structure of the brain of savants is truly unique: in Kim Peak, for example, the hemispheres of the brain are not separated at all.

While some scientists are arguing about the causes of the syndrome, others are ready to put the production of geniuses on stream almost tomorrow. Neuroscientists Bruce Miller from the University of California and Alan Snyder from the University of Sydney independently scanned the electromagnetic activity of the brains of several savants and obtained completely identical results. It turns out that in the arterial region of the left temporal lobe there is a “zone of genius.” For the vast majority of people, it is turned off from birth: electromagnetic activity in this part of the brain is practically zero. If you stimulate its work, then the person will become a genius, the scientists thought and were already reaching for scalpels, when at the last moment they decided to limit themselves to magnetic stimulation. During the experiment, five out of seventeen volunteers improved their performance in arithmetic calculations and drawing several times. “Their creativity increased by forty percent. The subjects were able to tap into unconscious reservoirs,” says Snyder. Of course, the result is not very impressive, but neurophysiologists did not place much hope in such a weak method of influence. Now, if at least one volunteer agreed to craniotomy and implantation of neurostimulators... But there are no fools yet. And artificially bred savants, respectively, too.

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All over the world schizophrenia affects about 1% of people. This disabling disease manifests itself in a wide variety of symptoms and syndromes. Clinical polymorphism of schizophrenia for a long time made taxonomy difficult of this mental disorder and the classification of its clinical forms: various, often polar theories appeared, mainly pathopsychological and clinical aspects were discussed. At the same time, the brain substrate of schizophrenia has been considered within the framework of the stratification model for more than 100 years (Jackson J. H., 1835-1911).

Modern ideas are based mainly on new clinical and biological aspects and data neuroscience(Neuroscience). This concept in English-speaking countries conventionally unites sections of brain science: neuropsychology, cognitive psychology and psychophysiology. The alliance is logical due to the general idea: the normal psyche and pathologies are a product of the brain (that is, they are not outside the body, so to speak, transcendentally), as well as due to common methodological approaches, the introduction of advanced technologies in the field of neuroimaging and progress in psychodiagnostics.

Purpose of this article: describe the historical background for the emergence of the modern neurocognitive model of schizophrenia and describe the neurocognitive symptoms and syndromes of schizophrenia, since cognitive psychology (CP) and clinical neuropsychology (CNP) are in demand in psychiatry relatively recently, and their methods are not yet used in routine medical practice. In a number of cases (social agnosia, social apraxia), we will talk about the semiotics of schizophrenia, which has not previously been described in Russian literature. Let us briefly dwell on the historical and methodological aspects of two scientific directions that have a clear tendency to merge, dominant in the formation of modern models of schizophrenia.

Cognitive psychology (cognitive- lat. knowledge, cognition) originated in the USA in the 50s of the 20th century. The philosophers Descartes, Hume and Kant played a historical role in the development of modern cognitive psychology. Descartes' idea of ​​mental structure formed the basis of the research method for studying one's own psyche. Hume's empirical approach led him to the laws of association of ideas, which became the basis for the classification of mental processes. For Kant, reason is the structure, experience is the facts that fill the structure. He distinguished three types of mental structures in the study of cognition: dimensions, categories and schemas. The theoretical basis of cognitive psychology was the work of K. Levin and E. Tolman on the dependence of human behavior on his subjective representation of the surrounding reality - the so-called cognitive maps. The founders include R. Atkinson, D. Bruner, D. Norman, F. Hader, W. Naiser, G. Simon. Modern cognitive psychology, when assessing the nature of the psyche, proceeds from a computer metaphor: the human cognitive system is considered as a system with a device for input, storage, and output of information, taking into account its throughput. Cognitive psychology today is a rapidly growing field of knowledge due to the rapid development of computer technology and the emergence of new theoretical research in the field of psychology. It borrows theories and methods from 10 major areas of research: perception, pattern recognition, attention, memory, imagination, language function, developmental psychology, reasoning and problem solving, and human and artificial intelligence.

Clinical neuropsychology originally developed as the science of local brain lesions. The modern approach defines clinical neuropsychology more broadly as a system of views not only on local disorders, but as a scientific vision of the contribution of different brain structures to the provision of individual mental processes, the psyche as a whole and behavior. Approaches to the assessment of symptoms and syndromes have also changed fundamentally. The new approach covers integrative brain activity aimed at processing unusual socially significant information. Thus, in modern clinical neuropsychology, disorders of mental processes in the physical and social world are reasonably separated. Clinical and anatomical syndromes characterizing disorders of the social “I” are described. The latter stands out as a unit independent of the body image or the somatic image of the “I”. The methodology of clinical neuropsychology, based on comparison of the results of neuropsychological testing with the results of brain imaging, has made great progress in understanding the essence of brain processes in schizophrenia. New technologies of modern clinical psychology, such as, for example, the method of recording single cell potentials (single cell recording), make it possible to accurately record brain regions involved in the disease process. These studies provide new information about structural and functional disorders of the brain, structural features of neuronal networks and brain metabolism in schizophrenia and allow them to be correlated with the structure of cognitive processes.

Neurosciences have made it possible to “put an end to” long debate about intellectual impairment in schizophrenia. The theoretical field of schizophrenia for a long time was formed either on the idea of ​​basic intellectual impairments that did not separate schizophrenia and brain diseases, or on the idea of ​​​​the incomparability of schizophrenia with neurological disorders. The latter direction dominated psychiatry for a long time, as a result of which brain processes were either ignored or completely denied, and schizophrenia began to be interpreted as a mental disorder without global cognitive impairment. Thus, in the works of M. Ya. Sereisky, A. V. Snezhnevsky, E. Bleuler, M. Bleuler and many others, the theory was actively promoted that in schizophrenia it is not the intellect that suffers, but the ability to use it. In accordance with these views, intellectual impairments were interpreted as pseudo-organic, and the final conditions were interpreted as potentially reversible (vesanic dementia). It is worth mentioning the widespread opinion about supposedly often outstanding abilities in premorbid schizophrenia and about accelerated intellectual development, which was interpreted as a vulnerability factor for the disease. It was believed that reversible dementia becomes apparent only in patients who have had schizophrenia for a long time due to the neurotoxicity of the manifest stage.

This view has changed dramatically over the past few decades. Neurocognitive methods have shown that decreased intelligence (general cognitive functioning) is present in primary patients, not being the result of psychosis or chronicity of the disease (chronification), as well as the influence of medications. It is particularly important that cognitive decline precedes the development of psychotic manifestations. In the prognosis of the development of schizophrenia, deviations in intellectual development turned out to be significant, which is manifested in very early childhood by phonation disturbances, changes in the tempo and general expressiveness of speech, speech motor features, changes in the tempo and general expressiveness of speech, motor and speech echophenomena. Those who subsequently become ill with schizophrenia study worse during their school years and do not keep up with the school curriculum. A. David et al. in a methodologically verified study of intellectual functions in schizophrenia, they examined 50 thousand men called up for military service in 1969-1970. Subsequently, 195 people developed schizophrenia. As it turned out, risk factors for developing schizophrenia there was a clear decrease in intellectual quotient (IQ) according to Wechsler’s method. In schizophrenia, the decrease in intelligence is approximately 10 points from the normal IQ according to the Wechsler method. In this regard, J. Gold and P. Harvey emphasize that a clear decrease in intellectual function is important for assessing neurocognitive function in schizophrenia.

In addition to general intellectual decline in schizophrenia, it was found decrease in individual cognitive processes. They are based on a deficit of intellectual functioning in schizophrenia in general. Individual cognitive problems in schizophrenia include disorders of attention, memory, perception, speed of comprehension of information, executive functions (planning, purposefulness of actions, initiation and programming of behavior), contextual and conceptual components of thinking. Executive functioning- a term proposed by A. Baddeley (1986) to describe the way of managing and processing the information most important for the formation of behavior. It's about planning and decision-making, about correcting mistakes to shape responses to new challenges. Patients with schizophrenia showed impaired performance on neuropsychological testing, revealing impairments in working memory, cognitive flexibility, and planning. Analysis of cognitive impairment has shown that patients with schizophrenia perform significantly worse on a wide range of neurocognitive tests than healthy people in the general population. Their level of cognitive functioning is on average 1-3 standard deviations below the norm corresponding to the same educational and age group. In terms of decreased cognitive functioning, especially in terms of attention and working memory, patients with schizophrenia are second only to patients with organic brain lesions, and in some characteristics (concentration and switching of attention) they come out on top. The brain mechanisms of semantic memory defects in schizophrenia include dysfunction of the temporoparietal regions of the cerebral cortex. A decrease in executive functions is associated with pathology of the frontal regions of the brain. Attention disorders, which predetermine the pathology of associative thinking, are caused by a violation of the frontotemporal regions, which results in the loss of the ability of patients with schizophrenia to suppress inappropriate associations.

Factor analysis of the clinical and psychopathological structure of schizophrenic symptoms using methods for assessing cognitive functions showed that cognitive impairment is not distributed among psychopathological syndromes and symptoms, but forms a separate factor. Therefore, at present, the proposed S. Marder et al. is increasingly recognized. five factor model of schizophrenia, in which, along with positive, negative and affective registers, factor of disorganization of thinking, including pathology of cognitive functions:

• disorientation,
• conceptual disorganization,
• abstraction disorders,
• attention disorders,
• decreased volitional capabilities,
• absent-mindedness.

Thus, cognitive impairment in patients with schizophrenia began to be considered as an independent syndrome within the framework of a dimensional (i.e. multifactorial) model.
Attention to the cognitive sphere in schizophrenia is explained by the fact that, while remaining invisible, “curtained” by bright and distinct productive and negative symptoms, cognitive impairments shape the level of social adaptation of patients and determine their quality of life. The ability to solve everyday problems, as Velligan D. J. showed in his study, has a low correlation with the psychopathological symptoms of the disease in schizophrenia. As part of this study, materials were collected proving the existence of a strong association between cognitive dysfunction and certain social problems in schizophrenia. Similar results were obtained in studies by Goldberg T.E. using the Global Assessment Scale (GAS), where a correlation was found between cognitive impairment, psychological and social functioning. Through the efforts of Kern R. S. et al. a link has been demonstrated between selective attention, oral memory and social skills in schizophrenia. Penn D. L. et al. also found a correlation between the early stages of information processing disorder and social skills. McEvoy et al. succeeded in demonstrating a connection between patients' poor ability to understand social interactions and their neuropsychological functioning. Cognitive dysfunction explains the extremely low effectiveness of rehabilitation programs for patients with schizophrenia. In addition, research has shown that working memory impairment and visual dysfunction limit the ability of a patient with schizophrenia to practice social skills. Corrigan P. W. studied the problems of everyday interaction in patients with schizophrenia. According to the authors, in order to better understand the interpersonal aspects of interaction that patients encounter in everyday life, deficits in the sphere of perception must first be reduced. Bellac A. S. believes that awareness of one's illness and the ability to regularly take necessary medications are also associated with aspects of cognitive functioning.

It is fundamentally important that the results of neuropsychological tests do not differ depending on the age of patients and the duration of the disease, which indicates that cognitive deficit is a basic fundamental symptom complex of schizophrenia, on which all other symptoms and syndromes are formed. These data are considered as an important argument in favor of theories of developmental disorders as a basic model of schizophrenia in contrast to supporters of the theory of neurodegeneration.

Meanwhile, in addition to general cognitive decline and deficits in individual cognitive processes, neuroscience postulates such phenomena in schizophrenia as social agnosia and social apraxia. These concepts of clinical neuropsychology are formed within the framework theories of mind(theory of mind), based on the fact that human behavior reflects anticipation of the behavior of other individuals based on the perception of their emotional state, which is based on the emotional tone of voice, facial expression and body position. Adequate behavior is based on a person’s conscious awareness of his own intentions and abilities, as well as his readiness to perceive and guess the intentions and thoughts of other people, and on the awareness of the presence of consciousness in others. Just as when recognizing the physical world, the system of processing and understanding social information necessarily includes two basic levels necessary for successful recognition:

• lower level of processing of social characteristics;
• the highest level, which contains prototypes of social
• subjects and social actions, consisting of a list of features and their significance for each prototype.

The list of prototypes of objects and actions, stored at the highest level, distinguishes the system of social recognition from the system of recognition of objects and actions in the physical world. This list includes subjects and actions that have social significance for the social “I” of a particular person, who needs to correlate the social significance of people and their actions with such categories as danger, deception, friendliness, as well as the success or failure of their own actions. With social agnosia, this system is disrupted, and violations of tasks within the theory of mind have been identified in the majority of patients with schizophrenia. Social agnosia develops in schizophrenia in the system of recognition of social subjects and their interactions and is associated with the image of “I”. Research has shown distinct deficits in the above-mentioned functions, also called social-cognitive. A direct result of social-cognitive dysfunction is impairment of social perception in schizophrenia(awareness of the contextual nuances of current events):

• lack of interest in contacts with other people;
• reduction or absence of the need to be understood by them (impaired mentalization);
• loss of the ability to rank current events and one’s place in them in order of significance.

The most dramatic manifestation of social agnosia in schizophrenia is violation of the image of “I” - model, in which the subject is represented in social space. It includes awareness of identity, as well as continuity over time, that is, an understanding of the immutability of one’s “I” in the past, present and future. The social model of “I” also includes a sense of subjective belonging - the ability to separate oneself from the outside world and a sense of awareness of actions. The modern research methods listed above have made it possible to establish that social agnosia is caused by damage to the frontotemporal regions of the brain. In the underestimation of the image of “I” and in the absence of will, the most significant painful changes are in the dorsal frontal regions of the brain and the temporal lobe. The defeat of these departments should explain withdrawal from social life, lack of will, loss of initiative and apathy. In cases of somatoagnosia, the lesions are located in the parietal lobe, which emphasizes the relative independence of the image of the social and bodily “I” and their disorders from a neuropsychological point of view.

Social apraxia(SA) is defined as a disturbance in functioning in the social world as a result of a disorder of goal-directed behavior associated with planning, anticipating outcomes, and executing socially significant actions. This term reflects the similarity between disorders of goal-directed actions in the physical world and behavioral disorders in society. Impairments in functioning and functioning in the social environment are manifested in everyday activities and in more complex types of activities, such as education, relationships with friends, and family relationships. Social apraxia is the most characteristic syndrome of schizophrenia, which manifests itself in social inaction, lack of purposefulness and disorganization of behavior. A special role in social apraxia belongs to damage to the orbitofrontal parts of the brain.

The study of cognitive impairment in schizophrenia naturally led to the emergence of a new direction in the treatment of this mental disorder. The fact that abnormalities in cognitive functioning are the main deficit in schizophrenia makes cognitive dysfunction appropriate target for treatment and recovery. Neurocognitive deficits are a major area of ​​therapeutic interest in the development of new treatment strategies, one of which, neurocognitive remediation, has been on the rise overseas in recent years.

Pioneers in the creation of programs to improve neurocognitive functions in schizophrenia were A. Delahunty and R. Morice (Australia). In 1993 they created program for restoring executive functions in schizophrenia(with elements of executive functions), which consisted of three modules:

• cognitive flexibility,
• working memory,
• planning.

Each module included a series of problems rated from extremely easy to easy, effectively providing learning progression. In the cognitive flexibility module, patients practiced specific cognitive choices between two sets of tasks. For example, they were given a page with a series of numbers and were asked to cross out the odd or even numbers. It was assumed that patients would not only complete the task, but would also change the direction of crossing out at the instructor's command. The working memory module required a person to comprehend two sets of information simultaneously and carry out their transformations sequentially. For example, a subject remembers the numbers of symbols connected sequentially by lines and transforms this information by remembering the lines in various other orders by their value. This task requires activation of the encoding function using mnemonic strategies. In the planning module, the participant planned a sequence of moves to achieve a certain goal. The patient had to organize the task in such a way as to create and use additional independently formed subgoals. An independent assessment of the effectiveness of the technique by A. Delahunty and R. Morice showed its significant potential. After class and 6 months after their completion, an increase in regional brain activity was recorded, confirmed by functional magnetic resonance therapy.

One of the first cognitive recovery programs was developed in 1994 by H. Brenner (USA). He created the most complete therapeutic program, which later became the basis for a new direction - the so-called integrated psychological therapy(IPT). This program attempts to increase basic cognitive problem solving abilities and improve motor skills. IPT is a step-by-step procedure designed for groups of 5-7 patients. The procedure consists of five subroutines:

• cognitive training,
• social perception,
• communication skills,
• problem-solving behavior
• social skills training.

The premise of the program is that progressive correction of cognitive deficits will facilitate the acquisition and improve the quality of more complex skills. Thus, the H. Brenner program included many different subprograms (cognitive restoration, occupational therapy, psychosocial intervention), where only one of them was aimed at the development of cognitive abilities. The authors stated that well-known rehabilitation programs (for example, occupational therapy) became effective only after preliminary neurocognitive training.

According to Spaulding W.D., attention training correlates with success in social learning of common social skills. A similar message was made by T. Wykes. They showed that the time of a simple response to a stimulus is associated with the level of social activity in schizophrenia, and that this final result is independent of the initial clinical condition of patients. Effective training to improve attention in schizophrenia has recently been conducted. The study authors showed that improving visual-motor skills can increase the level of social adaptation. It is curious that after the training, the patients were able to achieve the results of healthy people in test tasks.

Saykin J. A. demonstrated selective memory deficits in schizophrenia and the prospects of its training to improve the quality of life of patients with schizophrenia. In comparison with control groups, the author noted an improvement in the performance of patients with schizophrenia on motor tasks, tests of flexibility of thinking, retelling, auditory processing and attention. In this regard, Saykin J. A. considers the involvement of the middle temporal region in the deficit of cognitive functions in schizophrenia. The findings in this study are compatible with the left hemisphere dysfunction hypothesis in schizophrenia.

Timely diagnosis of the levels and specifics of neurocognitive deficits in clinical practice is extremely important, since it helps to predict its consequences in the form of disorders of psychosocial adaptation, including self-care, social and professional (educational) responsibilities, and level of independent living in society. Thus, correction of neurocognitive impairment is an important part of therapy for schizophrenia.

Obyedkov V. G., Gelda A. P. BSMU.
Published: Medical Panorama magazine No. 8, June 2007.

The IQ test has always been criticized because various studies have failed to determine whether the test has anything to do with predicting a person's likelihood of success in life. So is an IQ test completely useless? Most likely not. A new study has found that higher IQ levels are associated with a reduced risk of developing schizophrenia, even if there is a genetic predisposition.

What is characteristic of the disease?

Schizophrenia is a serious mental disorder whose symptoms manifest themselves through abnormal social behavior, paranoid delusions, and visual and auditory hallucinations. The disorder is mainly caused by genetic factors, although drug use and emotional trauma may also play a role. This new study is the largest to date to examine the relationship between schizophrenia and intelligence.

If you're really smart, your schizophrenia genes don't have much of a chance of developing, says Dr. Candler, lead author of the study from the University of Virginia.

How the study was conducted

The study analyzed the IQ scores of more than 1.2 million Swedish men. They were tested between the ages of 18 and 20, between 1979 and 1995. All schizophrenia-related hospitalizations occurred between 1986 and 2000. Candler's team found that there was a strong relationship between schizophrenia diagnoses and IQ test scores.

What really predicts your risk of schizophrenia is how far you deviated from the predicted IQ score you should have received from your parents. If your score is much lower, then the risk of developing schizophrenia is quite high. Not achieving the level of IQ that you should have, given your genetic makeup and family history, may most strongly predispose you to schizophrenia.

Risks

Of course, just because a high IQ reduces the risk of developing the disease does not mean that intelligent people are immune to the disorder. Researchers point to the most famous such case: mathematician John Nash. He was awarded the Nobel Prize in Economic Sciences in 1994 for his work in game theory. His life was depicted in the Russell Crowe film A Beautiful Mind. In fact, it was previously believed that high intelligence makes a person susceptible to schizophrenia, but the results of a recent study have debunked this misconception.

Content
Introduction……………………………………………………………………………………......... ....3
1. Schizophrenia. Reasons. Classification………………………………………………….4
2. Symptoms, diagnosis and treatment of schizophrenia.…………………………………………..6
3. Schizophrenia and intelligence………………………………………………………………...... ............9
Conclusion………………………………………………………………………………..……………….11
References………………………………………………………………………………………..…12

Introduction
Schizophrenia (from the Greek schizo - split and phren - soul) is a progressive mental illness, mainly affecting young people (hence another name for the disease - “dementia praecox”), determined by various productive symptoms and special personality changes (negative symptoms), the so-called a schizophrenic defect, in which autism, emotional impoverishment and loss of unity of mental processes are always present.
The clinic of schizophrenia is distinguished by a wide variety of clinical manifestations. In the symptoms of schizophrenia, it is customary to highlight the main, most characteristic manifestations of this disease, which are observed in all forms and types of course and determine its diagnosis. These include lethargy, inactivity, increasing as the disease progresses, indifference to the environment ("decrease in energy potential"), emotional impoverishment, phenomena of pathological isolation and alienation from the outside world, "withdrawal" (autism), "splitting", disintegration of unity mental processes, manifested in mismatch and discordance of thinking, emotions, motor skills and behavior in general.
Along with these negative symptoms, patients may also experience a variety of other productive symptoms, which creates a certain variety of different clinical manifestations of this disease.
Without treatment, schizophrenia is characterized by a long continuous or paroxysmal course. A state of improvement (remission) can occur at any stage of the disease, and the closer it is to practical recovery, the earlier the disease occurs and the longer it lasts.

1. Schizophrenia. Reasons. Classification
Schizophrenia is a polymorphic mental disorder characterized by the disintegration of affects, thinking processes and perceptions. Previously, the specialized literature indicated that about 1% of the population suffers from schizophrenia, but recent large-scale studies have shown a lower figure - 0.4-0.6% of the population. Men and women get sick equally often, but women usually develop schizophrenia later. In men, the peak incidence occurs at the age of 20-28 years, in women - at the age of 26-32 years. The disorder rarely develops in early childhood, middle age, or old age.
Schizophrenia is often combined with depression, anxiety disorders, drug addiction and alcoholism. Significantly increases the risk of suicide. It is the third most common cause of disability after dementia and tetraplegia. Often entails pronounced social maladjustment, resulting in unemployment, poverty and homelessness. Urban residents suffer from schizophrenia more often than people living in rural areas, but the reasons for this phenomenon remain unclear. Treatment of schizophrenia is carried out by specialists in the field of psychiatry.
Causes of schizophrenia
The causes have not been precisely established. Most psychiatrists believe that schizophrenia is a multifactorial disease that occurs under the influence of a number of endogenous and exogenous influences. Revealed as hereditary........

References
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4. Lombroso. Genius and madness. - M., 2002
5. Schizophrenia. Clinic and pathogenesis / ed. A. V. Snezhnevsky. M.: Medicine, 1969.

According to modern pathopsychological studies, patients , suffering schizophrenia, perform poorly on tests of intellectual activity. First of all, there is a loss of programming ability and difficulty in planning activities, a decrease in executive function, doubts and difficulty in solving problems.

Psychometric research methods in psychiatry, which are so popular in the United States, turned out to be most in demand when studying the intelligence of patients with schizophrenia.

The Wechsler test (WAIS) showed that patients with schizophrenia have a decrease in average IQ scores. They are significantly below the expected value of -100.

In studies by K. Fritt and E. Johnston (2005), the average IQ of patients with schizophrenia was 93, compared with 111 in a group of patients seeking help for other neurological and mental disorders.

Many psychiatrists believe that intellectual impairment probably does not have specificity in various forms of schizophrenia, but in this disease identification, self-identification and self-esteem are always distorted (Sverdlov L.S., 1986).

According to most researchers, In schizophrenia, intellectual impairment can be noted long before the clear onset of the disease.

According to research conducted in Israel, younger men who later developed schizophrenia also had lower IQ test scores, about 5 points below the average. Moreover, the violations became greater the closer the testing time was to the first episode of schizophrenia. Young people who had already been diagnosed with schizophrenia before testing averaged IQ scores 15 points below controls.

Previously it was believed that placement in a psychiatric hospital and especially a long stay in it could increase thinking disorders in schizophrenia. It is now generally accepted that this is not the only or even the main cause of intellectual impairment in people with schizophrenia.

Patients with schizophrenia who have taken various psychotropic drugs sometimes say that the drugs slow down their thinking and require strain when performing any tasks. However, most studies refute this point of view. Most likely, schizophrenia-specific cognitive impairment cannot be enhanced by psychotropic drugs, at least in the early years.

There is no connection between the severity of hallucinations, delusions and intelligence indicators of patients with schizophrenia, for example, determined by IQ value. But this indicator, in particular the decrease in its value, correlates well with the poverty of speech and the degree of its disorganization.