Formulating Cognitive Functioning to Guide Personalised Treatment for People Diagnosed With Mental Disorders

IF 4.7 2区医学 Q1 PSYCHIATRY

Acta Psychiatrica Scandinavica Pub Date : 2026-04-05 Epub Date: 2025-04-10 DOI:10.1111/acps.13811

Kelly Allott, Shayden Bryce, Katie Douglas, Alexandra Stainton, Stephen J. Wood, Christopher R. Bowie

{"title":"Formulating Cognitive Functioning to Guide Personalised Treatment for People Diagnosed With Mental Disorders","authors":"Kelly Allott, Shayden Bryce, Katie Douglas, Alexandra Stainton, Stephen J. Wood, Christopher R. Bowie","doi":"10.1111/acps.13811","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Objective and subjective cognitive impairment are highly prevalent in mental disorders and transdiagnostic phenomena. Cognitive impairment is associated with poorer functional outcomes and therefore requires treatment, but little guidance is available for clinicians. The aim of this article is to provide guidance for formulating an individual's cognitive profile and how this can be used to personalise treatments for optimum cognitive and functional outcomes.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We first critique current models of psychopathology in relation to assessing and addressing cognitive functioning in the clinic. This is followed by a description of key methods for assessing objective and subjective cognitive functioning and how this information can be used to formulate a patient's cognitive profile and tailor treatment.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Within current models of psychopathology, cognition is inadequately or simplistically represented, is only viewed from a deficit lens without considering strengths, does not consider subjective perceptions of cognitive functioning, and therefore, generally does not provide utility for guiding clinical practice. Both the profile of cognitive functioning (strengths and weaknesses) and estimated change from premorbid levels are key considerations for tailoring cognitive and functional treatments. Cognitive profile and change can be assessed using standardised cognitive tests through normative and idiographic methods, respectively. Subjective perception of cognitive functioning is a neglected but important additional aspect of cognitive functioning that warrants assessment. The complete cognitive profile can be used to guide the selection of cognition-focused treatments, including psychoeducation, lifestyle adaptations, cognitive remediation, compensatory strategies, environmental supports, psychological therapy, and medication review.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>We propose that cognition should be assessed in addition to presenting psychopathology because it is an independent transdiagnostic predictor of functional outcomes, which can enhance personalised clinical care. We recommend assessing both objective and subjective cognitive functioning to formulate the personalised treatment for optimal functional outcomes and promote a culture of recovery that includes cognitive health.</p>\n </section>\n </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 5","pages":"573-587"},"PeriodicalIF":4.7000,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13811","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Psychiatrica Scandinavica","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/acps.13811","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/10 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Objective and subjective cognitive impairment are highly prevalent in mental disorders and transdiagnostic phenomena. Cognitive impairment is associated with poorer functional outcomes and therefore requires treatment, but little guidance is available for clinicians. The aim of this article is to provide guidance for formulating an individual's cognitive profile and how this can be used to personalise treatments for optimum cognitive and functional outcomes.

Methods

We first critique current models of psychopathology in relation to assessing and addressing cognitive functioning in the clinic. This is followed by a description of key methods for assessing objective and subjective cognitive functioning and how this information can be used to formulate a patient's cognitive profile and tailor treatment.

Results

Within current models of psychopathology, cognition is inadequately or simplistically represented, is only viewed from a deficit lens without considering strengths, does not consider subjective perceptions of cognitive functioning, and therefore, generally does not provide utility for guiding clinical practice. Both the profile of cognitive functioning (strengths and weaknesses) and estimated change from premorbid levels are key considerations for tailoring cognitive and functional treatments. Cognitive profile and change can be assessed using standardised cognitive tests through normative and idiographic methods, respectively. Subjective perception of cognitive functioning is a neglected but important additional aspect of cognitive functioning that warrants assessment. The complete cognitive profile can be used to guide the selection of cognition-focused treatments, including psychoeducation, lifestyle adaptations, cognitive remediation, compensatory strategies, environmental supports, psychological therapy, and medication review.

Conclusions

We propose that cognition should be assessed in addition to presenting psychopathology because it is an independent transdiagnostic predictor of functional outcomes, which can enhance personalised clinical care. We recommend assessing both objective and subjective cognitive functioning to formulate the personalised treatment for optimal functional outcomes and promote a culture of recovery that includes cognitive health.

Abstract Image

查看原文本刊更多论文

制定认知功能以指导精神障碍患者的个性化治疗

客观和主观认知障碍在精神障碍和跨诊断现象中非常普遍。认知障碍与较差的功能结果相关，因此需要治疗，但临床医生可获得的指导很少。本文的目的是为制定个人认知概况以及如何将其用于个性化治疗以获得最佳认知和功能结果提供指导。方法我们首先批判当前的精神病理学模型，这些模型与临床评估和解决认知功能有关。接下来是对评估客观和主观认知功能的关键方法的描述，以及如何使用这些信息来制定患者的认知概况和定制治疗。在目前的精神病理学模型中，认知是不充分的或简单的表征，只是从缺陷的角度来看，没有考虑到优势，没有考虑到认知功能的主观感知，因此，通常不能提供指导临床实践的效用。认知功能的概况（优势和劣势）和从发病前水平估计的变化是定制认知和功能治疗的关键考虑因素。认知概况和变化可以分别通过规范和具体的方法使用标准化的认知测试进行评估。认知功能的主观感知是认知功能的一个被忽视但重要的附加方面，值得评估。完整的认知概况可用于指导选择以认知为重点的治疗方法，包括心理教育、生活方式适应、认知补救、补偿策略、环境支持、心理治疗和药物回顾。结论：我们建议除了呈现精神病理外，还应评估认知，因为它是功能结局的独立跨诊断预测因子，可以增强个性化的临床护理。我们建议对客观和主观认知功能进行评估，以制定个性化的治疗方案，以获得最佳的功能结果，并促进包括认知健康在内的康复文化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Acta Psychiatrica Scandinavica 医学-精神病学

CiteScore

11.20

自引率

3.00%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.