Cognitive Subtypes in Psychotic Disorders
Summary
Psychotic disorders such as schizophrenia and bipolar disorder exhibit marked heterogeneity in cognitive functioning, with some individuals showing broad impairments while others retain relative strengths. Advances in neuropsychological assessment and data-driven techniques have revealed that grouping patients by cognitive performance can uncover clinically meaningful subtypes. These subtypes often span domains including processing speed, working memory, verbal learning and executive function. Identification of distinct cognitive profiles has implications for personalised treatment planning, prognostic evaluation and the development of targeted cognitive remediation interventions. Furthermore, neuroimaging studies have begun to link cognitive subtypes to differences in grey matter volume and functional connectivity, suggesting underlying neurobiological signatures. A transdiagnostic perspective emphasises that cognitive subtypes cut across traditional diagnostic categories, underscoring the need for dimension-based models of psychosis and the integration of cognitive stratification into clinical trials and routine care.
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Cognitive Subtypes in Psychotic Disorders publication trend
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Technical terms
Cognitive subtype: A subgroup of individuals characterised by similar patterns of cognitive performance across domains.
Clinical high risk for psychosis (CHR-P): A state marked by attenuated psychotic symptoms and functional decline signalling elevated risk for developing psychosis.
First-episode psychosis (FEP): The initial onset of psychotic symptoms and related clinical presentation in an individual.
Self-organising map: An unsupervised neural network algorithm that projects high-dimensional data onto a low-dimensional grid to reveal patterns.
K-means clustering: A partitioning method that divides data into a predefined number of groups by minimising within-group variance.
References
- Prevalence of cognitive impairments and strengths in the early course of psychosis and depression. Psychological Medicine (2023).
- Do Cognitive Subtypes Exist in People at Clinical High Risk for Psychosis? Results From the EU-GEI Study. Schizophrenia Bulletin (2024).
- Cognitive profiles across the psychosis continuum. Psychiatry Research (2024).
- Brain structure and function correlates of cognitive subtypes in schizophrenia. Psychiatry Research (2015).
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