Cognitive Neuropsychiatry最新文献

{"title":"Cognitive impairment in catatonia compared to other psychiatric disorders.","authors":"Joseph M Bianco, Joseph J Cooper, Victor A Valencia, Sebastian Andrade, Jason R Soble","doi":"10.1080/13546805.2026.2726325","DOIUrl":"https://doi.org/10.1080/13546805.2026.2726325","url":null,"abstract":"<p><strong>Introduction: </strong>Catatonia is a neuropsychiatric syndrome associated with cognitive impairments, yet the neurocognitive performance of catatonia relative to other psychiatric disorders is poorly understood. This study characterised neurocognitive profiles in patients with a history of catatonia compared to schizophrenia spectrum (SSD), bipolar disorder (BD), and major depressive disorder (MDD) across a comprehensive battery of neuropsychological tests.</p><p><strong>Methods: </strong>Sixty-seven adults who underwent neuropsychological assessment were classified into catatonia (<i>n</i> = 10), SSD (<i>n</i> = 23), BD (<i>n</i> = 19), and MDD (<i>n</i> = 15) groups. Composite z-scores were generated across six domains: language, visuospatial skills, memory, attention, processing speed, and executive functioning.</p><p><strong>Results: </strong>Global neurocognitive functioning was similar, and approximated population norms, in BD and MDD, but significantly lower in catatonia (z = -1.63) and SSD (z = -1.14) groups. Significant differences emerged in overall neurocognitive scores (<i>ηp²</i>= .47) and memory, attention, processing speed, executive functioning (ηp² = 0.30-0.41), but not language. Post hoc tests showed MDD and BD outperformed SSD and catatonia groups, with no differences within these pairs. Neurobehavioural examinations distinguished catatonia from SSD by increased affective blunting, withdrawal, psychomotor slowing, and slow mentation.</p><p><strong>Conclusions: </strong>Catatonia is associated with substantial neurocognitive impairment, most similar to SSD, but with distinct neurobehavioural features. Routine screening and targeted neurocognitive assessment may enhance diagnosis and understanding of catatonia.</p>","PeriodicalId":51277,"journal":{"name":"Cognitive Neuropsychiatry","volume":" ","pages":"1-12"},"PeriodicalIF":1.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterisation of alogia in people with schizophrenia using natural language processing. a comparative study with a group of people with bipolar disorder.","authors":"Alvaro Cavieres, Francisca Alonso, Amanda Cifuentes, Vanessa Acuña, Jorge Portal, Juan Satt, Monica Otero, Pablo Lopez-Silva","doi":"10.1080/13546805.2026.2703583","DOIUrl":"https://doi.org/10.1080/13546805.2026.2703583","url":null,"abstract":"<p><strong>Methods: </strong>Ninety participants were recruited for the study, distributed equally in three groups: schizophrenia (SZ), bipolar disorder (BD), and healthy controls (HC). All participants described scenes depicting people interacting with each other in everyday social situations, and their cognitive functioning was assessed using the screen for cognitive impairment in Psychiatry (SCIP). Clinical status was assessed with the Brief Psychiatric Rating Scale (BPRS). Speech samples were explored with metrics that quantify speech production and complexity.</p><p><strong>Results: </strong>People with schizophrenia exhibited lower verbal production and reduced sentence complexity compared to healthy controls, while the bipolar disorder group showed values largely overlapping with controls. Across the pooled patient sample (SZ + BD), negative symptom severity was associated with multiple linguistic measures, including mean length of utterance (r = -0.384, BF₁₀ = 14.03, 95% CI [-0.571, -0.138]), syntagms, discourse complexity, and lexical-morphological indices, whereas positive symptoms showed little or no association with language metrics<b>.</b> Better cognitive functioning was associated with greater linguistic richness across most measures.</p><p><strong>Conclusions: </strong>The findings from this study suggest that poverty of speech, as captured by NLP-derived measures, is more prominent in schizophrenia than in bipolar disorder and healthy controls within the present sample. The observed associations with cognitive performance highlight the close relationship between language production and cognition, but do not establish a causal dependence. Rather than prompting a re-examination of alogia's classification among negative symptoms, these results underscore the need for integrative models that account for the well-known covariation between negative symptoms and cognitive functioning.</p>","PeriodicalId":51277,"journal":{"name":"Cognitive Neuropsychiatry","volume":" ","pages":"1-15"},"PeriodicalIF":1.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical response and facial emotion recognition following repetitive transcranial magnetic stimulation in treatment-resistant bipolar depression.","authors":"Dong Zhao, Jin Ma, Zhigang Sun, Yumei Wang, Ning Chang, Lijing Ma","doi":"10.1080/13546805.2026.2668422","DOIUrl":"10.1080/13546805.2026.2668422","url":null,"abstract":"<p><strong>Introduction: </strong>Repetitive transcranial magnetic stimulation (rTMS) is increasingly used in treatment-resistant depression, but its relationship with facial emotion recognition in bipolar depression remains unclear. This study examined clinical outcomes and changes in facial emotion recognition observed over an rTMS treatment course in patients with treatment-resistant bipolar depression.</p><p><strong>Methods: </strong>We conducted a naturalistic observational study using pseudonymized routinely collected clinical data from adults with bipolar depression who underwent rTMS. Depressive symptoms, baseline neurocognitive measures, and facial emotion recognition outcomes were analyzed. Between-group comparisons were performed for responders versus non-responders and remitters versus non-remitters. Spearman correlations examined associations between HDRS-17 reduction and facial emotion recognition changes. Because multiple emotion-specific correlations were tested, false discovery rate correction was applied.</p><p><strong>Results: </strong>Among the included patients, 116 were classified as clinical responders and 67 as non-responders. Baseline characteristics were similar between groups, except that responders showed higher baseline fear recognition accuracy. Across the sample, facial emotion recognition accuracy increased and reaction times decreased over the treatment course, with the largest accuracy gain observed for sadness recognition. However, improvements in facial emotion recognition were not significantly associated with reductions in depressive symptoms after correction for multiple comparisons. In exploratory logistic regression analyses, higher post-treatment sadness recognition accuracy was associated with lower odds of clinical response, although the overall model showed limited explanatory power.</p><p><strong>Conclusion: </strong>In this naturalistic observational sample of patients with treatment-resistant bipolar depression receiving rTMS, improvements in facial emotion recognition were observed over the treatment course, but these changes were not clearly associated with clinical response. Controlled studies are needed to determine whether these changes are attributable to rTMS and to clarify their clinical significance.</p>","PeriodicalId":51277,"journal":{"name":"Cognitive Neuropsychiatry","volume":" ","pages":"116-131"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-diagnostic analysis of loneliness and working memory deficits in youths with first-episode severe mental disorders.","authors":"Wei-Sheng Huang, Li-Chi Chen, Ya-Mei Bai, Shih-Jen Tsai, Ju-Wei Hsu, Mu-Hong Chen","doi":"10.1080/13546805.2026.2700254","DOIUrl":"10.1080/13546805.2026.2700254","url":null,"abstract":"<p><strong>Introduction: </strong>Few studies have investigated whether youth with first-episode severe mental disorders experience higher levels of loneliness than healthy people. The relationship between loneliness and working memory deficits in such patients has yet to be investigated.</p><p><strong>Methods: </strong>In all, 25, 28, and 24 youth with first-episode schizophrenia, first-episode bipolar disorder, and first-episode major depression, respectively, and 32 healthy controls were enrolled. All participants fulfilled the self-reported UCLA Loneliness Scale and underwent a working memory task.</p><p><strong>Results: </strong>Patients with schizophrenia, bipolar disorder, and major depressive disorder had higher levels of loneliness compared with the individuals in a control group. Youth with bipolar disorder and those with schizophrenia performed worse on the working memory task than the controls. We found a positive association between errors on the working memory task and loneliness levels.</p><p><strong>Conclusions: </strong>Loneliness and working memory deficits appear to be cross-diagnostic phenomena in adolescents and young adults with first-episode severe mental disorders.</p>","PeriodicalId":51277,"journal":{"name":"Cognitive Neuropsychiatry","volume":" ","pages":"146-158"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive profiles in psychosis: comparing those experiencing uni- or multisensory versus multimodal hallucinations.","authors":"Wei Lin Toh, Mikaela Bere, Adrienne Bell, Susan Lee Rossell","doi":"10.1080/13546805.2026.2689331","DOIUrl":"10.1080/13546805.2026.2689331","url":null,"abstract":"<p><p><b>Introduction:</b> A vast body of cognitive research in psychosis has focused on auditory hallucinations, though more recent studies are turning towards other sensory modalities. This study aimed to compare the cognitive profile of persons experiencing uni- or multisensory versus multimodal hallucinations.</p><p><p><b>Methods:</b> Participants with primary diagnosis of a psychotic disorder were subdivided into those experiencing uni- or multisensory (UMS; <i>n </i>= 31) versus multimodal (MM; <i>n </i>= 28) hallucinations relative to non-clinical controls (NC; <i>n </i>= 32). Cognitive assessment comprised the MATRICS Consensus Cognitive Battery, supplemented by a Colour Word Interference Test. Analyses of variance (ANOVAs) and correlation analyses were performed.</p><p><p><b>Results:</b> The UMS and MM groups performed significantly worse than the NC group on some cognitive domains (i.e. speed of processing, attention/vigilance, working memory, verbal learning), but not others (i.e. reasoning and problem-solving, social cognition). For visual learning, the MM group performed significantly worse than the NC group only, whereas for inhibition, the UMS group performed significantly worse than the NC group only.</p><p><p><b>Conclusion:</b> A novel cognitive profile associated with multimodal hallucinations was documented. Dissociation between performance of the two clinical groups on visual learning and inhibition suggests these cognitive domains may be of relevance to hallucinations, pending further investigations.</p>","PeriodicalId":51277,"journal":{"name":"Cognitive Neuropsychiatry","volume":" ","pages":"132-145"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defying dualism in functional neurological disorder … again: response to Scamvougeras and Castle.","authors":"Jon Stone","doi":"10.1080/13546805.2026.2641667","DOIUrl":"10.1080/13546805.2026.2641667","url":null,"abstract":"<p><p>This commentary responds to an article by Anton Scamvougeras and David Castle arguing that contemporary accounts of Functional Neurological Disorder (FND) overemphasise neurobiology and that the disorder should be understood primarily as a psychiatric condition. There are areas of agreement, including the need for a biopsychosocial model and acknowledgement that some academic and public discourse about FND has minimised psychological factors. However, proposed distinctions between neurological and psychiatric disorders based on the presence or absence of pathology are conceptually unstable. Many neurological conditions, such as Parkinson's disease and epilepsy, are intrinsically neuropsychiatric, while others, including migraine and Tourette syndrome, lack pathology on standard investigations. FND also raises another fundamental question: whether a neurologist's role is to seek pathological disease or to diagnose and manage neurological symptoms. Claims that current literature promotes a purely biological model are overstated. The proposal that the psychiatric level is the best way in which to understand FND promotes the idea that psychiatric factors are universally explanatory. Instead, the evidence supports a multi-level understanding of the aetiology and mechanisms of FND symptoms, including how they arise from altered brain networks. A non-dualistic framework, as seen, for example, in chronic nociplastic pain, allows a psychiatric perspective to sit alongside a neurobiological one, without one having to dominate the other.</p>","PeriodicalId":51277,"journal":{"name":"Cognitive Neuropsychiatry","volume":" ","pages":"100-106"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Every time dualism is mentioned in clinical debate, a philosopher is thrown out of heaven.","authors":"Vaughan Bell","doi":"10.1080/13546805.2026.2640129","DOIUrl":"10.1080/13546805.2026.2640129","url":null,"abstract":"<p><p>Scamvougeras and Castle argue that appeals to dualism are frequently deployed to dismiss psychological explanations in favour of framing functional neurological disorder (FND) as a \"brain disorder.\" Yet participants on all sides of this debate often conflate \"dualism\" with Cartesian substance dualism. Contemporary philosophy of mind, by contrast, accommodates multi-level, non-reductive accounts that are fully compatible with the brain as the organ of the mind. Positions such as property dualism and non-reductive physicalism demonstrate that recognising psychological mechanisms does not entail commitment to a non-physical substance, nor denial of the dependence of mental processes on brain function. A more pressing question, therefore, is why psychological explanations are resisted at all, given that scientific psychology, as opposed to folk psychology, does not necessarily equate the psychological with conscious will or personal control. We may be better off by ditching debates about dualism and focusing instead on the integration of neurobiological and psychological accounts within evidence-based models of FND, with each explanatory level evaluated on its merits.</p>","PeriodicalId":51277,"journal":{"name":"Cognitive Neuropsychiatry","volume":" ","pages":"97-99"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stances and levels in the explanation of functional neurological disorder.","authors":"Philip Gerrans, Jon Jureidini","doi":"10.1080/13546805.2026.2723877","DOIUrl":"10.1080/13546805.2026.2723877","url":null,"abstract":"<p><strong>Introduction: </strong>Psychiatric phenomena are emergent properties of complex, distributed neurobiological systems. They are candidates for interlevel reduction between psychiatric and neurobiological levels of explanation. At the same time, they can initially be characterised in terms of what Daniel Dennett called the Intentional stance.</p><p><strong>Methods: </strong>We review arguments drawn from the philosophy of science about the nature and explanation of emergent systemic phenomena and show how they apply to the explanation of psychiatric disorder. Examples from placebo effects, dopamine function and chronic pain illustrate how higher-level psychological explanations and lower-level neurobiological accounts interact within network-based, non-modular systems. The debate about the explanatory priority of neurobiological and psychogenic explanations of functional neurological disorder provides a case study of these ideas.</p><p><strong>Results: </strong>We show how the concept of a posteriori interlevel reduction is consistent with treating psychogenic explanation as a version of the Intentional Stance approach advocated by Daniel Dennett. The Intentional Stance is consistent with an integrative multilevel explanation of psychiatric phenomena rather than an interpretative heuristic autonomous from lower levels of explanation.</p><p><strong>Conclusion: </strong>Clinicians should adopt a stance of pluralism: using the intentional stance as an initial, indispensable framework while remaining agnostic about explanatory priority until integrative, multilevel models are empirically validated. Functional Neurological Disorder, like chronic pain, thus requires coordinated explanation across interacting systemic levels.</p>","PeriodicalId":51277,"journal":{"name":"Cognitive Neuropsychiatry","volume":" ","pages":"107-115"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological roots of emotional ambivalence: from brain networks to clinical implications.","authors":"Giulio Verrienti","doi":"10.1080/13546805.2026.2695647","DOIUrl":"10.1080/13546805.2026.2695647","url":null,"abstract":"<p><p><b>Introduction:</b> Emotional ambivalence - the coexistence of conflicting positive and negative feelings toward the same object, event, or person - has been historically emphasized in psychiatry and psychoanalysis and is increasingly studied in affective neuroscience. While Bleuler identified ambivalence as central to schizophrenia and Freud described its coexistence of love and hate, contemporary psychology extends the concept to mixed emotions, decision-making, and attitudes such as nostalgia. This review aims to synthesize evidence on the neural basis of ambivalence, clarify its distinction from uncertainty, and explore its clinical and therapeutic implications.</p><p><p><b>Methods:</b> A narrative review methodology was adopted, integrating findings from functional neuroimaging, electrophysiology, and meta-analyses. Studies of ambivalent evaluation, decision-making under conflict, and mixed affective states were examined. Analyses focused on distributed neural networks and their dynamic spatiotemporal organization, including oscillatory EEG and ERP dynamics.</p><p><p><b>Results:</b> Ambivalence consistently engages a distributed network involving the anterior cingulate cortex (conflict monitoring), insula (interoception), prefrontal regions (valuation/regulation), and salience circuits, together with temporoparietal and posterior midline regions involved in meta-cognitive and social-cognitive integration. Evidence from electrophysiological studies further indicates that ambivalence unfolds dynamically over time, reflecting rapid interaction between positive and negative affective representations rather than static co-activation. Pharmacological and neuromodulatory interventions show potential to recalibrate dysfunctional circuits.</p><p><p><b>Conclusions:</b> Ambivalence represents a distinct neurobiological state whose dysregulation contributes to psychopathology. It can be conceptualized as a transdiagnostic dimension of affective integration, reflecting the capacity to integrate competing emotional representations. Therapeutic strategies may enhance tolerance of ambivalence and improve clinical outcomes.</p>","PeriodicalId":51277,"journal":{"name":"Cognitive Neuropsychiatry","volume":" ","pages":"159-168"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional neurological disorders: misunderstanding \"Dualism\".","authors":"Anton Scamvougeras, David Castle","doi":"10.1080/13546805.2026.2664426","DOIUrl":"10.1080/13546805.2026.2664426","url":null,"abstract":"<p><p>Psychological and psychiatric explanations for Functional Neurological Disorders (FND) are routinely dismissed as embodying \"dualism\" or \"mind-body dualism\", strongly implying that any notion of psychogenicity should be rejected outright. This reflects a widespread misunderstanding. DSM5 nomenclature and recent mainstream literature emphasise neurobiological causation - framing FND as a \"multi-network brain disorder\" or \"dysregulation of neural circuitry\" - while downplaying psychological formulations, despite high rates of psychiatric symptomatology and the fact that the majority of clinicians worldwide continue to prefer psychogenic models and treatment with psychotherapy. The charge of dualism is misplaced: while Cartesian substance dualism has been correctly rejected by modern neuroscience, the term is now commonly misused to criticise any distinction between neurological and psychiatric causation. We argue that neuropsychiatric conditions exist on a clinically useful continuum from predominantly neurological to predominantly psychiatric/psychological disorders, while fully accepting that all are ultimately brain-based. Psychiatric symptomatology, clinician perspectives, and response to psychological approaches place FND firmly on the psychiatric/psychological side of this continuum. Framing FND as driven by psychological/psychiatric engines offers far greater clinical utility and therapeutic direction than reductionistic neurobiological models. We conclude that psychological/psychiatric conceptualisations remain the most valid and effective framework for understanding and managing FND.</p>","PeriodicalId":51277,"journal":{"name":"Cognitive Neuropsychiatry","volume":" ","pages":"85-96"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}