BMC Psychiatry最新文献

Background: Cognitive impairment is a major contributor to functional disability in individuals with psychosis. However, there is limited qualitative research on the everyday experience of cognitive impairments in psychosis. Addressing this gap could inform more person-centered care. This study aimed to gain a deeper understanding of how cognitive impairments affect daily life among individuals living with psychosis.

Methods: A qualitative phenomenological approach was employed. Data was collected through semi-structured individual interviews with nine participants, aged 30 to 55 years, diagnosed within the psychosis spectrum. Inclusion required evidence of cognitive impairment, operationalized as scoring at least one standard deviation below the normative mean on one or more cognitive domains assessed by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Interviews were transcribed and analyzed using thematic analysis.

Results: Four main themes emerged: (1) Acknowledging and making sense: participants recognized diverse manifestations of cognitive difficulties in their daily life and sought to interpret and contextualize them in order to make sense of their experiences; (2) Navigating the importance and challenges of social life: social interactions were valued but often hindered by sensory overload and feelings of loneliness, and were mostly limited to family; (3) Adjusting to a slow pace: participants described a daily life marked by passivity and difficulties in planning and structuring meaningful activities, leading to lowered expectations for activities and stimulation; and (4) Using everyday workable strategies: coping with cognitive challenges including choosing less crowded environments, engaging in activities requiring short periods of concentration, as well as adopting an accepting attitude towards life.

Conclusions: By exploring participants' lived experiences of cognitive difficulties, this study highlights not only the heterogeneity in how such impairments are manifested, but also the varying degrees of awareness with which they are understood. These insights support the need for individually tailored approaches, both in adapting treatments such as cognitive remediation and in developing interventions that empower individuals to enhance their awareness of their challenges and support strength-based coping strategies.

Trial registration: Clinical trial number: not applicable.

Objective: Individuals at clinical high risk for psychosis exhibit cognitive and neurophysiological abnormalities that may predict transition to schizophrenia. Event-related potentials (ERPs), including mismatch negativity (MMN), P300, and N100, have been proposed as candidate biomarkers. This systematic review and meta-analysis aimed to synthesize evidence on ERP alterations in CHR populations compared with healthy controls (HCs) and to evaluate their predictive value for transition.

Methods: Following PRISMA guidelines, PubMed and Medline were systematically searched from January 1996 to March 2025. Studies reporting ERP data in CHR and HC participants, and longitudinal studies distinguishing converters (CHR-T) from non-converters (CHR-NT), were included. Data extraction and quality assessment followed Cochrane standards, and pooled effect sizes were estimated using random- or fixed-effects models.

Results: Thirty-six studies were included. Compared with HCs, CHR individuals demonstrated significantly reduced P300 amplitude (MD (95%CI) = -2.35 (-3.31, -1.39), p < 0.05) and attenuated duration- and frequency-deviant MMN (MD (95%) = 0.31 (0.20, 0.43), p < 0.01), whereas N100 showed no significant group differences. In longitudinal analyses, only duration-deviant MMN differentiated CHR converters from non-converters (p < 0.05). Sensitivity analyses confirmed robustness of the findings.

Conclusions: ERP abnormalities, particularly reduced duration-deviant MMN, represent promising biomarkers for early detection of psychosis risk and may aid in risk stratification and intervention planning. These results highlight the potential utility of ERPs as clinically accessible, low-cost neurophysiological tools for predicting transition in CHR populations.