[Analysis of cognitive status in patients with different nosologies and clinical variants of very late manifesting schizophreniform psychosis].

Abstract

Objective: To study and compare the features of cognitive functioning in patients with very late-manifesting schizophreniform psychosis (VLMSP) depending on the clinical variants of the disease.

Material and methods: The study included 61 patients (58 females, 3 males) aged 63 to 78 years. All patients met the ICD-10 criteria for psychosis and had no signs of dementia. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA) score and the Mini-Mental State Examination (MMSE). Statistical analysis was performed using non-parametric methods.

Results: Patients with severe polymorphic psychotic symptoms had the most pronounced cognitive deficit (MMSE on Day 0 was 22.5 [20; 26] points, MoCA on Day 0 was 16 [12; 19] points, p<0.05), which partially improved after treatment, but remained below the reference values (MMSE on Day 28 was 24.5 [22; 26] points, MoCA on Day 28 was 18.5 [17; 22] points). In patients with paranoid symptoms, cognitive impairment was less pronounced (MMSE on Day 0 was 26 [24; 28] points, MoCA on Day 0 was 0 [17; 24.5] points) and stable (MMSE on Day 28 was 27 [25.5; 29.5] points, MoCA on Day 28 was 21 [17; 25] points). In the group where affective-delusional symptoms prevailed, the cognitive deficit was minimal (MMSE on Day 0 was 27.5 [27; 28.5] points, MoCA on Day 0 was 24 [23; 26.5] points) and completely reduced after treatment (MMSE on Day 28 was 29 [28; 30] points, MoCA on Day 28 was 26 [25; 28] points).

Conclusion: The study showed significant differences in cognitive status in patients with VLMSP depending on the clinical variant of the disease. The results emphasize the need for an individualized approach to diagnosing and treating VLMSP and the importance of monitoring cognitive functions for early detection of neurodegenerative processes.