Cognitive Performance associated to functional outcomes in stable outpatients with schizophrenia

Area of Science:

• Neuroscience
• Psychiatry
• Cognitive Psychology

Background:

• Cognitive impairment is a core feature of schizophrenia, affecting a majority of patients.
• Limited data exists on the prevalence of cognitive deficits and their impact on functional outcomes in large schizophrenia cohorts.
• Second-generation antipsychotics are standard treatment, but their effect on cognition requires further investigation.

Purpose of the Study:

• To estimate the prevalence of cognitive impairment across various domains in a large sample of schizophrenia outpatients.
• To investigate the relationship between cognitive deficits and functional outcomes in this population.
• To identify predictors of functional disability in schizophrenia.

Main Methods:

• A cross-sectional study involving 672 schizophrenia outpatients on stable treatment for at least six months.
• Cognitive function was assessed using the EPICOG-SCH battery, evaluating working memory, executive function, verbal memory, and processing speed.
• Clinical severity and functional impairment were measured using the CGI-SCH and WHO DAS-S scales.

Main Results:

• A high prevalence of cognitive impairment was observed, with 61.5% of patients meeting criteria.
• The most common impairments were in executive function (85.9%) and processing speed (38.1%).
• Working memory deficits (Letter-Number Sequencing) were strongly associated with functional disability (OR = -0.16442, p = 0.0004).

Conclusions:

• Cognitive impairment, especially in executive function and processing speed, is highly prevalent in schizophrenia outpatients.
• Working memory impairment is a key predictor of functional disability, underscoring its clinical significance.
• Regular monitoring of cognitive function is essential for assessing and managing everyday functional capacity in schizophrenia patients.