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Approximately one-third of patients with schizophrenia or schizoaffective disorder exhibit cognitive impairment, which is significantly associated with adverse childhood experiences, negative psychopathology, and poorer functional outcomes. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

June 19, 2026Open Access

Cognitive Impairment in Patients With Schizophrenia and Its Relationship With Adverse Childhood Experiences

Key Points

This study aims to evaluate cognitive impairment in patients with schizophrenia and its relationship with adverse childhood experiences (ACEs).
Enrolled 75 clinically stabilized patients with schizophrenia or schizoaffective disorder (stability for at least 4 weeks).
Utilized psychometric scales including SCIP, PANSS, FAST, and ACE-International Questionnaire.
Conducted multiple regression analysis to identify predictors of cognitive impairment.
32% of patients exhibited global cognitive impairment.
Significant predictors include older age (r = −0.245; p = 0.034), primary education level (p = 0.008), and antipsychotic polytherapy (p = 0.016).
Total SCIP score showed a significant association with physical neglect (p = 0.004) and parental separation (p = 0.018).

Abstract

Cognitive impairment is now considered a core feature of schizophrenia (SCZ) that contributes to poor clinical outcomes. Clinical and socioenvironmental factors may play a key role in shaping cognitive functioning. In the present study, we aim to assess cognitive impairment in patients with SCZ or schizoaffective disorder and to explore whether adverse childhood experiences (ACEs) and clinical factors are associated with cognitive functioning. We enrolled clinically stabilized patients with SCZ or schizoaffective disorder (stability for at least 4 weeks). The following psychometric scales were used: the Screen for Cognitive Impairment in Psychiatry (SCIP), the Positive and Negative Syndrome Scale (PANSS), the Functioning Assessment Short Test (FAST), and the ACE‐International Questionnaire. The sample consisted of 75 patients. Overall, 32% showed global cognitive impairment. The main factors associated with cognitive impairment were older age ( r = −0.245; p = 0.034), primary education level ( p = 0.008), low socioeconomic status ( p = 0.029), antipsychotic polytherapy ( p = 0.016), and the PANSS negative syndrome scale ( p < ~0.001). The total SCIP score was significantly associated with physical neglect ( p = 0.004) and parental separation or divorce ( p = 0.018). A negative correlation was observed between total SCIP score and functional outcome ( p < ~0.001). Multiple regression analysis showed that low educational attainment, greater psychotic symptoms severity, and poorer functioning significantly predicted cognitive impairment ( p = 0.005, 0.02, and 0.048, respectively). These findings suggest that approximately one in three patients with SCZ or schizoaffective disorder had cognitive impairment, which was associated with poorer functional outcomes. Cognitive impairment appears to be related to exposure to childhood adversity as well as negative psychopathology.

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