Cognitive Deficits and Duration of Untreated Psychosis: Implications of Psychosocial Rehabilitation in Schizophrenia

Introduction: Schizophrenia is a severe psychiatric disorder that affects 1 in 223 adults worldwide. It is characterized not only by positive and negative symptoms but also by significant impairments in cognitive functioning. These cognitive impairments often persist even when other symptoms are relatively stable and are considered the important predictors of functional outcomes. Objectives: To determine the prevalence of cognitive impairment among patients with schizophrenia and to examine the relationship between the duration of untreated psychosis (DUP) and cognitive impairment, including the predictive effect of DUP on cognitive decline. Methods: This descriptive and cross-sectional study was conducted over 6 months at the Department of Psychiatry, Pakistan Institute of Medical Sciences, Islamabad, Pakistan. A total of 130 patients diagnosed with schizophrenia were recruited after informed consent. Cognitive function was assessed using the Addenbrooke’s Cognitive Examination Revised (ACE-R) and the Mini-Mental State Examination (MMSE). Correlation and regression analyses were performed to explore the associations between DUP and cognitive impairment. Results: Cognitive impairment was prevalent in 80% of participants. DUP showed a significant negative correlation with both MMSE and ACE-R scores, indicating that longer untreated psychosis was associated with greater cognitive decline. However, regression analysis did not demonstrate a statistically significant predictive effect of DUP on cognitive impairment. Conclusion: Cognitive impairment is highly prevalent among patients with schizophrenia and shows a significant association with longer DUP. These findings emphasize the importance of early intervention and incorporating cognitive rehabilitation into psychosocial management to enhance the recovery outcomes.