The relationship between cognitive functioning and psychopathology in patients with psychiatric disorders: a transdiagnostic network analysis

• Published in: Psychological medicine 2023-01, Vol.53 (2), p.476-485
• Main Authors: Chavez-Baldini, UnYoung, Nieman, Dorien H., Keestra, Amos, Lok, Anja, Mocking, Roel J. T., de Koning, Pelle, Krzhizhanovskaya, Valeria V., Bockting, Claudi L.H., van Rooijen, Geeske, Smit, Dirk J. A., Sutterland, Arjen L., Verweij, Karin J. H., van Wingen, Guido, Wigman, Johanna T.W., Vulink, Nienke C., Denys, Damiaan
• Format: Article
• Language: English
• Subjects: Anhedonia; Anxiety; Anxiety disorders; Attention; Bipolar disorder; Cannabis; Cognition; Cognition & reasoning; Cognition Disorders - psychology; Cognitive ability; Cognitive functioning; Cognitive impairment; Cross-Sectional Studies; Drug use; Hedonic response; Humans; Intelligence tests; Marijuana; Memory; Mental depression; Mental disorders; Network analysis; Obsessive compulsive disorder; Original; Original Article; Outpatient care facilities; Psychiatry; Psychopathology; Psychosis; Psychotic Disorders - epidemiology; Psychotic Disorders - psychology; Psychotic symptoms; Schizophrenia; Statistical analysis; Substance abuse; Substance use; Verbal memory; Visual attention; Visual perception
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291721001781

Patients with psychiatric disorders often experience cognitive dysfunction, but the precise relationship between cognitive deficits and psychopathology remains unclear. We investigated the relationships between domains of cognitive functioning and psychopathology in a transdiagnostic sample using a data-driven approach. Cross-sectional network analyses were conducted to investigate the relationships between domains of psychopathology and cognitive functioning and detect clusters in the network. This naturalistic transdiagnostic sample consists of 1016 psychiatric patients who have a variety of psychiatric diagnoses, such as depressive disorders, anxiety disorders, obsessive-compulsive and related disorders, and schizophrenia spectrum and other psychotic disorders. Psychopathology symptoms were assessed using various questionnaires. Core cognitive domains were assessed with a battery of automated tests. Network analysis detected three clusters that we labelled: general psychopathology, substance use, and cognition. Depressive and anxiety symptoms, verbal memory, and visual attention were the most central nodes in the network. Most associations between cognitive functioning and symptoms were negative, i.e. increased symptom severity was associated with worse cognitive functioning. Cannabis use, (subclinical) psychotic experiences, and anhedonia had the strongest total negative relationships with cognitive variables. Cognitive functioning and psychopathology are independent but related dimensions, which interact in a transdiagnostic manner. Depression, anxiety, verbal memory, and visual attention are especially relevant in this network and can be considered independent transdiagnostic targets for research and treatment in psychiatry. Moreover, future research on cognitive functioning in psychopathology should take a transdiagnostic approach, focusing on symptom-specific interactions with cognitive domains rather than investigating cognitive functioning within diagnostic categories.