Integrating Clinical Neuropsychology and Psychotic Spectrum Disorders: A Systematic Analysis of Cognitive Dynamics, Interventions, and Underlying Mechanisms

Medicina (Kaunas). 2024 Apr 17;60(4):645. doi: 10.3390/medicina60040645.

Abstract

Background and Objectives: The study aims to provide a comprehensive neuropsychological analysis of psychotic spectrum disorders, including schizophrenia, bipolar disorder, and depression. It focuses on the critical aspects of cognitive impairments, diagnostic tools, intervention efficacy, and the roles of genetic and environmental factors in these disorders. The paper emphasizes the diagnostic significance of neuropsychological tests in identifying cognitive deficiencies and their predictive value in the early management of psychosis. Materials and Methods: The study involved a systematic literature review following the PRISMA guidelines. The search was conducted in significant databases like Scopus, PsycINFO, PubMed, and Web of Science using keywords relevant to clinical neuropsychology and psychotic spectrum disorders. The inclusion criteria required articles to be in English, published between 2018 and 2023, and pertinent to clinical neuropsychology's application in these disorders. A total of 153 articles were identified, with 44 ultimately included for detailed analysis based on relevance and publication status after screening. Results: The review highlights several key findings, including the diagnostic and prognostic significance of mismatch negativity, neuroprogressive trajectories, cortical thinning in familial high-risk individuals, and distinct illness trajectories within psychosis subgroups. The studies evaluated underline the role of neuropsychological tests in diagnosing psychiatric disorders and emphasize early detection and the effectiveness of intervention strategies based on cognitive and neurobiological markers. Conclusions: The systematic review underscores the importance of investigating the neuropsychological components of psychotic spectrum disorders. It identifies significant cognitive impairments in attention, memory, and executive function, correlating with structural and functional brain abnormalities. The paper stresses the need for precise diagnoses and personalized treatment modalities, highlighting the complex interplay between genetic, environmental, and psychosocial factors. It calls for a deeper understanding of these neuropsychological processes to enhance diagnostic accuracy and therapeutic outcomes.

Keywords: bipolar disorder; brain function; cognitive impairment; dementia; neurobiological pattern; neuropsychology; psychotic spectrum; schizophrenia.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / psychology
  • Cognition / physiology
  • Cognitive Dysfunction / diagnosis
  • Humans
  • Neuropsychological Tests*
  • Neuropsychology / methods
  • Psychotic Disorders* / diagnosis
  • Psychotic Disorders* / psychology
  • Psychotic Disorders* / therapy
  • Schizophrenia / complications
  • Schizophrenia / diagnosis
  • Schizophrenia / physiopathology

Grants and funding

The publication fees of this manuscript have been financed by the Research Council of the University of Patras, Greece.