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Cognitive Impairments in Different Stages of Schizophrenia: Scoping Review

Cognitive Impairments in Different Stages of Schizophrenia: Scoping Review

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Recieved: 04/15/2023

Accepted: 02/26/2026

Published: 03/13/2026

Keywords: cognitive deficit; schizophrenia; attenuated psychotic symptoms; first episode; schizophrenia symptoms; cognitive functioning; review

Pages: 120–129

DOI: 10.11621/npj.2026.0209

Available online: 13.03.2026

To cite this article:

Kafarov, E.R. (2026). Cognitive Impairments in Different Stages of Schizophrenia: Scoping Review. National Psychological Journal, 21(2) , 120–129. https://doi.org/10.11621/npj.2026.0209

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Issue 2, 2026

Kafarov, E.R. The Mental Health Research Center

Abstract

Background. The significance of cognitive dysfunction in schizophrenia is the subject of modern psychiatric and cognitive research. In particular, some authors propose to consider cognitive impairments as “core” symptoms of schizophrenia. The cognitive status affects the functional outcome and the level of social readaptation. The investigation of changes in the cognitive status of patients with schizophrenia at various stages of the disease, as well as the prognostic and differential role of cognitive diagnostics of patients, remains an urgent task.

Objective. The aim is to structure information on the current state of cognitive impairment at various stages of schizophrenia.

Methods
. The research presents a literature review of studies on cognitive functions and their impairments at various stages of schizophrenia (premorbid, prodrome with high risk for psychosis, the first episode of schizophrenia). Publications were selected from the Russian Science Citation Index (RSCI), Web of Science, and PubMed databases according to the PRISMA-ScR guidelines, using the following keywords: cognitive dysfunction in schizophrenia, cognitive impairment in schizophrenia, the first episode, attenuated psychotic symptoms, ultra-high risk for psychosis. The review included articles on empirical research, metaanalytic studies, and systematic reviews.

Results
. The obtained research data indicate that cognitive dysfunction manifests itself in the premorbid period, long before the manifestation of the disease. Patients with an extremely high risk of psychosis demonstrate a significant severity of cognitive deficit associated with the severity of erased psychotic symptoms. Cognitive deficit is not a consequence of past psychotic episodes and does not depend on the duration of an untreated psychosis.

Conclusions
. The level of cognitive functioning in patients at the pre-psychotic states of schizophrenia development has an important prognostic significance along with the criteria of extremely high risk and familial risk. Cognitive deficit is a separate, “core” group of symptoms for schizophrenia, not secondary to productive symptoms.

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To cite this article:

Kafarov, E.R.. Cognitive Impairments in Different Stages of Schizophrenia: Scoping Review. // National Psychological Journal 2026. 2. Pages120–129. doi: 10.11621/npj.2026.0209

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