Living with Psychosis and Cognitive Impairment: A Qualitative Study

Background: Cognitive impairment is a major contributor to functional disability in individuals with psychosis. However, few studies have explored the lived experience of managing these challenges—insights that could inform the development of more effective interventions. 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. Cognitive impairment was confirmed through neuropsychological testing. Interviews were transcribed and analyzed using thematic analysis. Results: Four main themes with two or three subthemes emerged: 1) Acknowledging and making sense; 2) Navigating the importance and challenges of social life; 3) Adjusting to a slow pace; and 4) Using everyday workable strategies. Conclusions: Living with psychosis and cognitive impairment often involves a tension between a desire for connection and the limitations imposed by cognitive difficulties. The study underscores the heterogeneity in both the expression and awareness of these challenges, and highlights the role of sensory gating difficulties in shaping daily experiences. The findings point to the relevance of Acceptance and Commitment Therapy for psychosis (ACTp)-informed interventions and targeted psychoeducation for relatives as promising avenues to enhance coping, reduce defeatist performance beliefs, and support re-engagement with daily life. Trial registration: Clinical trial number: not applicable.