Cognitive Dysfunctions in the Psychoses and their Impact on Patients’ Social Functioning

Abstract

Introduction

Impairment of neurocognitive functions, such as attention, memory or executive functions, as well as of social cognition, particularly of affect recognition and theory of mind, are frequently observed in people with Schizophrenia or other psychotic disorders. These dysfunctions are associated with poor real-life functioning. Social cognition deficits mediate in part the impact of neurocognitive dysfunction on functional outcome.

Aims

To review literature findings on prevalence, severity and association with functional outcome of neurocognitive and social cognitive deficits in schizophrenia and other psychotic disorders.

Methods

We searched PubMed for English/Italian or French full-text publications with the keywords.

schizophr*/psychosis/psychot*/AND neurocognitive/cognitive/neuropsychological/memory/attention/”executive function”/learning/”social cognition”/”theory of mind”/”affect recognition”/”acial emotion recognition”/”emotional intelligence”/”emot* recognition”. Furthermore, we manually searched the reference lists of relevant papers, systematic reviews and meta-analyses.

Results

In people with schizophrenia, schizoaffective disorder or bipolar disorder with psychotic features, neurocognitive and social cognition deficits were observed in all phases of the disorders, even after symptom remission. Some of these deficits were observed in subjects at high-risk to develop schizophrenia before psychotic onset. In all these subjects, cognitive deficits are associated with worse psychosocial functioning and poor quality of life. Pharmacological treatments do not alleviate cognitive deficits, which can also limit the benefit of other psychological or psychosocial interventions.

Conclusions

Neurocognitive and social cognition deficits need to be targeted by specific interventions to improve real-life functioning and quality of life of people with schizophrenia or psychotic disorders.

Disclosure of interest

AM received honoraria or advisory board/consulting fees from the following companies: Janssen Pharmaceuticals, Otsuka, Pfizer and Pierre Fabre.

SG received honoraria or advisory board/consulting fees from the following companies: Lundbeck, Janssen Pharmaceuticals, Hoffman-La Roche, Angelini-Acraf, Otsuka, Pierre Fabre and Gedeon-Richter.