Cognitive Impairment in Stable Schizophrenia: Insights from a Large-Scale Chinese Cohort

Objective This study aims to investigate the prevalence of cognitive impairment in patients with stable schizophrenia, analyze factors influencing its occurrence, and examine its impact on functional outcomes. Methods This study includes a sample of 8309 participants diagnosed with stable schizophrenia in China between March and November 2022. Social-demographic and health-related data of the participants were collected. Their cognitive function was assessed by the Chinese Brief Cognitive Test (C-BCT). To evaluate factors associated with cognitive function, Ordinary Least Squares (OLS) regression and Geographically Weighted Regression (GWR) were applied. Logistic regression was further employed. Results The proportion of patients with cognitive impairment (defined as cognitive function 1 standard deviation below the population mean on the C-BCT) was 73.68% (N = 6122) in China. Age, disease course, and diabetes were significantly negatively associated with cognitive function, whereas education and waist circumference showed significant positive associations, with significant spatial heterogeneity across the seven geographical regions. Patients treated with 5-HT _1A receptor partial agonists (OR = 0.89, 95% CI: 0.81-0.97) and D2 receptor partial agonists (OR = 0.81, 95% CI: 0.73-0.90) were negatively associated with the occurrence of cognitive impairment. Conclusions This study represents the first large-scale cross-sectional analysis of cognitive function in patients with stable schizophrenia and the initial generalized application of C-BCT cognitive tools. The study found for the first time that the subgroups using 5-HT1A receptor partial agonists or D2 receptor partial agonists showing less impairment. In the future, attention, awareness and interventions should be researched in depth.