Are cognitive deficits more severe among people with treatment-resistant schizophrenia than treatment responders?

BackgroundGiven the robust association of cognitive deficits (CD) with community functioning in people with schizophrenia and the inconsistent findings from the limited research on CD among people with treatment-resistant schizophrenia (TRS), we evaluated the neurocognitive functions of patients with TRS.MethodsWe retrospectively collated data on cognition and selected demographic and clinical variables of 181 patients with TRS and 59 with treatment-responsive schizophrenia (non-TRS) admitted to a psychiatric rehabilitation facility from 2010 to 2019. The Brief Assessment of Cognition in Schizophrenia (BACS) was used to evaluate cognitive function. Multivariate analysis was utilised to compare the BACS scores of the two groups.ResultsTRS patients had more severe CD than non-TRS patients, with the BACS composite score (p = .003), verbal memory and learning (p = .003), working memory (p = .043), and psychomotor speed (p = .004) significantly worse in the TRS group. There was no significant difference in the BACS scores between the 60% of the TRS patients who were treated with clozapine and the TRS patients (40%) treated with other antipsychotics.ConclusionCD are more severe among patients with TRS than in non-TRS cohorts. The pathophysiology of CD among people with TRS and efficacy of interventions to ameliorate CD among this cohort warrant greater scrutiny.