{"title":"Cognitive deficits in individuals with comorbid personality disorder and schizophrenia: A scoping review","authors":"Anouck Chalut , Stéphane Potvin , Laura Iozzino , Marie-Ange Binette , Hubert Fiset-Renaud , Sara Abou Chabake , Tania Lecomte","doi":"10.1016/j.scog.2025.100403","DOIUrl":"10.1016/j.scog.2025.100403","url":null,"abstract":"<div><h3>Objective</h3><div>It is estimated that approximately 40 % of individuals diagnosed with schizophrenia also meet the diagnostic criteria for a personality disorder. This comorbidity is associated with an unfavorable prognosis for the illness. Given that cognition is currently the best predictor of recovery, this study aims to characterize the cognitive profiles of individuals with comorbid personality disorders and schizophrenia by reviewing literature from the past 24 years. We sought to determine whether the cognitive deficits differed from that of individuals with only a schizophrenia diagnosis, and to further characterize these differences.</div></div><div><h3>Method</h3><div>Articles were gathered from PubMed, Google Scholar, Web of Science, PsychInfo, PsychNet, MedLine, and EMBASE. They were selected based on the following inclusion criteria: (a) use of neuropsychological or social cognition measures, (b) explicit mental disorder diagnosis established using validated diagnostic tools, (c) participants with a comorbid personality disorder and schizophrenia diagnosis, and (d) results of neuropsychological measures specific to participants with this type of comorbidity.</div></div><div><h3>Results</h3><div>A total of 10 articles were included. Of these, six clinically established a personality disorder diagnosis, while five measured traits associated with various personality disorders. Due to the heterogeneity of methodologies across the studies, no statistical conclusions could be drawn.</div></div><div><h3>Discussion/conclusion</h3><div>Our review did highlight a greater presence of studies on antisocial personality, with few on other personality disorders or traits. Given the high comorbidity of personality disorders in schizophrenia, and the important impact of cognition on functioning, including social cognition, more studies are warranted. Recommendations for both clinicians and researchers are proposed.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"43 ","pages":"Article 100403"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145474355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peijuan Wang , Chao Liu , Xueyan Zhu , Qi Yan , Ning Shen , Jiajia Shi , Qinyu Lv , Xiangdong Du
{"title":"A clinical control study of modified electroconvulsive therapy and sodium valproate as enhancement strategies for ultra-treatment-resistant schizophrenia","authors":"Peijuan Wang , Chao Liu , Xueyan Zhu , Qi Yan , Ning Shen , Jiajia Shi , Qinyu Lv , Xiangdong Du","doi":"10.1016/j.scog.2025.100396","DOIUrl":"10.1016/j.scog.2025.100396","url":null,"abstract":"<div><h3>Background</h3><div>A substantial proportion of patients with schizophrenia show an inadequate response to clozapine, a condition termed ultra-treatment-resistant schizophrenia (UTRS). While modified electroconvulsive therapy (MECT) and sodium valproate are common augmentation strategies, head-to-head trials directly comparing their efficacy and safety are lacking. This study aimed to directly compare the short-term efficacy and safety of MECT versus sodium valproate as augmenting agents to clozapine in patients with UTRS.</div></div><div><h3>Methods</h3><div>This was an 8-week, single-center, randomized controlled trial. Seventy inpatients meeting diagnostic criteria for UTRS were randomly assigned to receive either MECT augmentation (<em>n</em> = 35) or sodium valproate augmentation (n = 35), both in addition to their ongoing clozapine treatment. The primary outcome was the change in the Positive and Negative Syndrome Scale (PANSS) total score. Secondary outcomes included changes in cognitive function assessed by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and laboratory safety parameters.</div></div><div><h3>Results</h3><div>At week 8, the MECT group demonstrated a significantly greater reduction in PANSS total score compared to the sodium valproate group (<em>p</em> < 0.01). The response rate, defined as a ≥ 25 % reduction in PANSS total score, was also significantly higher in the MECT group (48.6 %, 17/35) than in the valproate group (14.3 %, 5/35, <em>p</em> < 0.01). Regarding cognitive function, there was no statistically significant difference in the change of the RBANS total score between the two groups from baseline to endpoint (<em>p</em> = 0.24). Both treatments were generally well-tolerated, with no significant differences observed in key laboratory safety parameters, including leukocyte counts, liver function, and glucose levels, either within or between groups (all <em>p</em> > 0.05).</div></div><div><h3>Conclusion</h3><div>In this cohort of inpatients with UTRS, 8 weeks of MECT augmentation appeared to be more effective than sodium valproate in reducing overall psychotic symptoms. These findings should be considered preliminary, and neither intervention demonstrated short-term benefits for cognitive function. Future studies with longer follow-up periods are warranted to assess the durability of response and should include a clozapine-only control arm to confirm the true value of these augmentation strategies.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"43 ","pages":"Article 100396"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Self-reported cognitive functioning on the behavior rating inventory of executive function in psychotic disorders: Effects of gender, education and cognitive functioning","authors":"Eivind Haga Ronold , Rune Raudeberg","doi":"10.1016/j.scog.2025.100399","DOIUrl":"10.1016/j.scog.2025.100399","url":null,"abstract":"<div><h3>Introduction</h3><div>Psychotic disorders (PD) are among the most severe mental disorders and cognitive impairment contributes to this. Few studies have investigated self-reported executive function (srEF)in PD using the Behavior Rating Inventory of Executive Function Adult version (BRIEF-A) and have found varying results. Population characteristics could contribute to this heterogeneity. The current study thus reported BRIEF-A scores in a sample with PD, and how this was affected by gender, education and cognitive function measured by The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).</div></div><div><h3>Methods</h3><div>BRIEF-A consist of 9 scales, two indices (Behavioral Regulation Index [BRI] and Metacognition Index [MI]), ands a summary score Global Executive Composite (GEC). T-scores (high score = difficulties) from 260 patients (99 women, mean age 24.58) was included. Independent samples t-tests were used to compare means between genders. Gender, RBANS Total Scale scores and years of education were used to predict BRIEF-A scores in general linear mixed models.</div></div><div><h3>Results</h3><div>For the full sample, the BRIEF-A the GEC showed a marginally impaired T-score (T >60) and the MI showed highest scores. Females had a GEC and MI score above clinical cutoff (T ≥65), and had significantly more srEF difficulties on all scales except Inhibit and Self-Monitor. Gender and global cognition showed some multivariate interactions, but these effects were small.</div></div><div><h3>Conclusions</h3><div>The current study indicates srEF marginally impaired meta-cognition in PD, enhanced by gender. Future studies should investigate srEF longitudinally to see how this develops following psychosis onset and identify groups in need of targeted treatments like cognitive remediation.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"43 ","pages":"Article 100399"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jayda L. Melnitsky , Joanne Yoon , Megan R. Mayer , Anne P. Lewandowski , Madison C. Teets , James Gangwisch , Corey Reuteman-Fowler , Wenbo Tang , Philip D. Harvey , Richard S.E. Keefe , Joshua T. Kantrowitz
{"title":"Keep your participants close, but your informants closer? The added value of high and low contact informants to supplement self-report for the cognitive impairment of schizophrenia","authors":"Jayda L. Melnitsky , Joanne Yoon , Megan R. Mayer , Anne P. Lewandowski , Madison C. Teets , James Gangwisch , Corey Reuteman-Fowler , Wenbo Tang , Philip D. Harvey , Richard S.E. Keefe , Joshua T. Kantrowitz","doi":"10.1016/j.scog.2026.100422","DOIUrl":"10.1016/j.scog.2026.100422","url":null,"abstract":"<div><h3>Background</h3><div>The input of an “informant,” a person in the participant's life who can evaluate levels of functioning, can supplement potentially unreliable self-reports in schizophrenia. However, this adds to the complexity of clinical trial design. To evaluate the relative utility of information from informants and participants in a clinical trial context, we compared the participant (self-report), informant, and interviewer ratings for the Schizophrenia Cognition Rating Scale (SCoRS).</div></div><div><h3>Methods</h3><div>We compared the participant (self-report), informant, and interviewer ratings using paired <em>t</em>-tests, Pearson correlations and Fisher z-transformation and inter-rater reliability (IRR). To assess to importance of informant “closeness,” we conducted a categorical analysis split by informant contact (above/below 30 h/week) or relationship to the participant (family or friend).</div></div><div><h3>Results</h3><div>The informant ratings for the SCoRS Total Score had an excellent IRR, (ICC = 0.91), similar to interviewer IRR (0.91). The highest level of impairment was rated by the interviewers, followed by the informant and participant self-reports. The correlation for the SCoRS total between the interviewer and informant (<em>r</em> = 0.92) was significantly larger than between the interviewer and participant self-reports or informant and participant self-reports (both <em>p</em> < 0.01). There were no significant correlations between contact hours and total ratings, and between-group correlations remained highly significant within the categorical analysis subgroups (<em>r</em> > 0.9).</div></div><div><h3>Conclusions</h3><div>Our results suggest that interviewers relied on informant reports significantly more than the participant self-report, even with an informant who spends as little as 2 h a week with a participant. Future research should assess the relationship of informant ratings with cognition or symptom scales.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"44 ","pages":"Article 100422"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sunghye Cho , Yan Cong , Aarush Mehta , Amir H. Nikzad , Sarah A. Berretta , Leily M. Behbehani , Mark Liberman , Sunny X. Tang
{"title":"Unique signatures in verbal fluency task performance in schizophrenia and depression","authors":"Sunghye Cho , Yan Cong , Aarush Mehta , Amir H. Nikzad , Sarah A. Berretta , Leily M. Behbehani , Mark Liberman , Sunny X. Tang","doi":"10.1016/j.scog.2025.100407","DOIUrl":"10.1016/j.scog.2025.100407","url":null,"abstract":"<div><h3>Background</h3><div>Verbal fluency tasks reveal consistent impairments among individuals with schizophrenia (SSD) and shed valuable insight on semantic and cognitive processing. However, comparisons with other psychiatric groups remain limited. Doing so may help clarify whether characteristics are unique to SSD versus shared across diagnoses. This study compared verbal fluency responses among participants with SSD, unipolar depression, and healthy volunteers (HV).</div></div><div><h3>Methods</h3><div>Participants with SSD (<em>n</em> = 64), unipolar depression (<em>n</em> = 70), and HVs (<em>n</em> = 37) completed letter- and category-guided verbal fluency tasks. Using automated pipelines, we extracted total correct responses, pause durations, first response latency, semantic and phonemic distances, and the number and size of semantic/phonemic clusters. Associations between fluency metrics and clinical ratings of speech disturbances (e.g., incoherence, inefficiency) were examined within patient groups.</div></div><div><h3>Results</h3><div>Groups differed significantly in total fluency scores, particularly on the category fluency task, with the greatest impairment in SSD and intermediate effects in depression. Significant pairwise group differences emerged in the number of semantic and phonemic clusters in the category task, while cluster size showed fewer differences. In HVs, both semantic and phonemic distances increased with longer pauses, suggesting strategic cluster switching. This pattern was absent in SSD and depression groups. SSD exhibited longer first latency and pauses relative to HVs; participants with depression showed no change in latency, but similarly prolonged pauses.</div></div><div><h3>Conclusion</h3><div>Individuals with SSD and depression exhibit distinct patterns in verbal fluency, with category tasks revealing more robust group differences. Automated fluency analysis offers a scalable approach for differentially detecting cognitive-linguistic impairments across psychiatric populations.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"43 ","pages":"Article 100407"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Starting from scratch: Ziermans et al. commentary","authors":"David Dodell-Feder , Steven M. Silverstein","doi":"10.1016/j.scog.2025.100414","DOIUrl":"10.1016/j.scog.2025.100414","url":null,"abstract":"","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"44 ","pages":"Article 100414"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ChengFei Duan , ChunHua Cao , MingLiang Ju , YanYan Wei , XiaoChen Tang , LiHua Xu , HuiRu Cui , YingYing Tang , ZhengHui Yi , Xin Wei , JiJun Wang , TianHong Zhang
{"title":"Divergent age-related cognitive impairments in first-episode psychosis","authors":"ChengFei Duan , ChunHua Cao , MingLiang Ju , YanYan Wei , XiaoChen Tang , LiHua Xu , HuiRu Cui , YingYing Tang , ZhengHui Yi , Xin Wei , JiJun Wang , TianHong Zhang","doi":"10.1016/j.scog.2025.100394","DOIUrl":"10.1016/j.scog.2025.100394","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive impairment is a core feature of first-episode psychosis (FEP), but its age-associated cognitive patterns remain unclear. Prior studies suggest FEP is associated with baseline cognitive deficits and accelerated decline, yet inconsistencies exist regarding whether cognitive aging in FEP mirrors or diverges from healthy aging.</div></div><div><h3>Methods</h3><div>We compared 378 drug-naive FEP patients and 477 healthy controls (HC) using the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB). Clinical symptoms were evaluated via the Positive and Negative Syndrome Scale (PANSS). Age-correlations with cognitive domains were analyzed via Pearson's coefficients and Fisher's z-transformation.</div></div><div><h3>Results</h3><div>FEP patients showed significant deficits across all cognitive domains (all <em>p</em> < 0.001) and disrupted age-associated cognitive patterns. In HC, age was associated with gradual declines in memory (e.g., HVLT-R <em>r</em> = −0.304, <em>p</em> < 0.001), working memory (<em>r</em> = −0.168, <em>p</em> < 0.001), and learning functions, aligning with normative aging. FEP patients showed a complex pattern: while some executive functions (e.g., Trail Making A) mirrored HC's negative age correlations, social cognition (<em>r</em> = 0.174, <em>p</em> < 0.001), attention (<em>r</em> = 0.125, <em>p</em> = 0.015), and specific learning domains exhibited positive age associations. Group comparisons revealed significant differences in age-cognition relationships for verbal memory, working memory, and overall cognitive composites (all <em>p</em> < 0.0028 after Bonferroni correction), indicating disrupted cognitive aging in FEP.</div></div><div><h3>Conclusions</h3><div>FEP disrupts normative cognitive aging patterns, characterized by atypical decline and compensatory improvements. These findings highlight the need for longitudinal studies to clarify mechanisms and inform age-adapted interventions.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"43 ","pages":"Article 100394"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea Fiorillo , Stefano Barlati , Matteo Di Vincenzo , Umberto Albert , Giuseppe Carrà , Bernardo Dell'Osso , Giovanni Martinotti , Mario Luciano , Antonio Vita
{"title":"Virtual reality–based cognitive remediation in severe mental illness: Current evidence from a narrative review","authors":"Andrea Fiorillo , Stefano Barlati , Matteo Di Vincenzo , Umberto Albert , Giuseppe Carrà , Bernardo Dell'Osso , Giovanni Martinotti , Mario Luciano , Antonio Vita","doi":"10.1016/j.scog.2026.100418","DOIUrl":"10.1016/j.scog.2026.100418","url":null,"abstract":"<div><div>Cognitive impairment is a pervasive feature across severe mental illnesses (SMIs), including schizophrenia spectrum disorders (SSDs), major depressive disorder (MDD), and bipolar disorder (BD), and is associated with poor functional outcomes and reduced quality of life. Cognitive remediation (CR) is an evidence-based psychosocial intervention aimed at improving cognitive functioning and daily functioning in individuals with SMI. In recent years, virtual reality (VR) has emerged as a promising modality for delivering CR in a more immersive, engaging, and ecologically valid manner. This narrative review synthesizes the current literature on the effectiveness of fully immersive VR-based CR interventions in SMI populations. Preliminary findings suggest that VR-CR may enhance treatment engagement, facilitate transfer of cognitive gains to real-life functioning, and support remote delivery. Although early results are encouraging, most available studies are limited by small sample sizes, short follow-up periods, and lack of standardized outcome measures. Further large-scale randomized controlled trials are needed to establish the long-term effectiveness, generalizability, and cost-efficiency of VR-CR approaches.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"44 ","pages":"Article 100418"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Smyrnis , G. Smyrnis , M. Lazaridi , A. Mantas , T. Karantinos , C. Klein , P. Maragos , N. Smyrnis
{"title":"Longitudinal measurements of inhibitory cognitive performance in patients with schizophrenia and bipolar disorder","authors":"A. Smyrnis , G. Smyrnis , M. Lazaridi , A. Mantas , T. Karantinos , C. Klein , P. Maragos , N. Smyrnis","doi":"10.1016/j.scog.2026.100426","DOIUrl":"10.1016/j.scog.2026.100426","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive impairment is a major determinant of functional outcome in psychotic spectrum disorders. Among cognitive domains, motor response inhibition has received limited longitudinal investigation. The present study examined the temporal course of inhibitory performance and its relationship with dimensional psychopathology in schizophrenia and bipolar disorder.</div></div><div><h3>Methods</h3><div>Thirty-eight outpatients (23 schizophrenia spectrum, 15 bipolar spectrum) from the e-Prevention project were followed for up to 26 months. At monthly or bi-monthly intervals, participants completed a computerized Go/No-Go task assessing accuracy, response speed and intra-individual variability of response speed. Linear mixed-effects models evaluated the effects of time, diagnosis and longitudinal change in symptom severity on performance, controlling for medication and neuropsychological variables.</div></div><div><h3>Results</h3><div>Accuracy declined over time in schizophrenia but slightly improved in bipolar disorder, indicating divergent longitudinal trajectories (F = 9.02, <em>p</em> = .007). Time had no effect on response speed and intra-individual variability of response speed in either group. Increased positive symptom severity was associated with reduced accuracy in bipolar disorder but not in schizophrenia (F = 4.85, <em>p</em> = .036). Finally, greater speed intra-individual variability of response speed correlated with higher disorganization scores across diagnoses (F = 5.54, <em>p</em> = .027).</div></div><div><h3>Conclusions</h3><div>This study provides preliminary evidence that inhibitory control exhibits distinct temporal patterns in schizophrenia and bipolar disorder. Schizophrenia could be marked by gradual accuracy decline, while in bipolar disorder, accuracy may show relative stability modulated by positive symptoms. Future work on larger samples should incorporate neurophysiology/neuroimaging, to elucidate the underlying neural mechanisms of these differences.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"44 ","pages":"Article 100426"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}