Mediating Effect of Sex-Related Differences in the Relationship Between Cognitive Functioning and Clinical Symptoms in Patients with Schizophrenia

Objective: Sex differences in patients suffering from schizophrenia are well established for clinical symptoms and a number of sociodemographic parameters, but not for cognitive functioning. Data on the relationship between cognition and clinical symptoms are also contradictory. This study was aimed at evaluating cognitive functions, symptomatology, and the relationship between these domains, with consideration of the sex of the patient.

Methods: Оne hundred and twenty-nine patients (55% males) diagnosed with paranoid schizophrenia in remission according to 10th revision of the International Statistical Classification of Diseases and Related Health Problems completed a broad battery of cognitive tests. Disease severity was measured by the Positive and Negative Syndrome Scale and Clinical Global Impression—Severity. Male and female patients were homogeneous in age, age of illness onset, duration of the disease, and severity of symptomatology.

Results: Patients showed a notable difference in cognitive functioning and in the pattern of links between cognitive functioning and clinical symptoms. Female patients demonstrated higher results in psychomotor speed, while male patients showed higher results in some aspects of executive functioning. The most prominent sex-related difference was that for each of the sexes, those cognitive functions that were more impaired relative to the group trend were associated more closely with the clinical symptomatology of schizophrenia.

Conclusion: Patients’ sex is a crucial factor mediating cognitive functioning and the symptomatology of schizophrenia.

Cite this article as: Lepilkina TA, Morozova MA, Alekseev AA. Mediating effect of sex-related differences in the relationship between cognitive functioning and clinical symptoms in patients with schizophrenia. Neuropsychiatr Invest. 2023;61(4):110-116.