# Revisiting Cognitive Deficits in Outpatients with Psychotic Disorders: A Transdiagnostic Comparison of Cognitive Performance While Accounting for Putative Confounding Factors

## TL;DR

This study compares cognitive performance in people with psychotic disorders and others, finding some cognitive issues persist even after accounting for non-cognitive factors.

## Contribution

The study provides new evidence that some cognitive deficits in psychotic disorders are not fully explained by confounding factors like stress or sleep.

## Key findings

- PSY group showed decreased performance in graphomotor speed, attention, and verbal tasks compared to other groups.
- After accounting for non-cognitive factors, group differences in verbal learning diminished but remained in other domains.
- Findings suggest some cognitive deficits in PSY cannot be attributed to momentary confounding factors.

## Abstract

Recent research suggests that cognitive deficits in individuals with psychotic disorders could be overestimated because poor cognitive test performance is partly attributable to non-cognitive factors. To further test this, we included non-hospitalized individuals with psychotic disorders (PSY, n = 38), individuals with attenuated psychotic symptoms (n = 40), individuals with obsessive-compulsive disorders (n = 39), and healthy controls (n = 38). Relevant cognitive domains were assessed using the MATRICS Consensus Cognitive Battery. Putative confounding non-cognitive factors—heart rate, self-reported stress, negative affect, performance-related beliefs, and actigraphy-derived sleep—were assessed before cognitive testing. A multivariate analysis of covariance was calculated to examine group differences in cognitive performance while controlling for non-cognitive factors. PSY showed decreased test performance in graphomotor speed, attention, and verbal tasks compared to the other groups, whereas non-verbal/visual-spatial tasks were unimpaired. After accounting for non-cognitive factors, group differences diminished in verbal learning, whereas differences in the other domains remained significant. Against our hypotheses, the present findings indicate that some cognitive deficits in PSY cannot be attributed to momentary confounding factors.