Cognitive Deficits in Persons with Functional Pain Syndrome: A Systematic Review

Background: Functional pain syndromes (FPSs) may have an incapacitating cognitive and psychological effect on daily life, with emerging and inconsistent evidence suggesting long-term pain may impact various cognitive domains. Methods: This paper aims to provide a systematic review of the literature published between 1980 and 2024, examining the cognitive deficits and associated psycho-social factors in adults with FPS. Results: A database search was conducted using EBSCOhost, PubMed, PsycInfo, PsycArticles, Web of Science, and ProQuest using the specific keywords. A total of 22 studies were included based on the predefined inclusion and exclusion criteria. The findings were organized across cognitive domains: attention, working memory, psychomotor and processing speed, memory, and executive function. Most studies reported significant impairments in selective, focused, and sustained attention, working memory, information processing speed, and short-term memory in patients with FPSs when compared to healthy controls. Executive function, visuo-perceptual abilities, and long-term memory showed inconsistent patterns across studies. Several studies highlighted the role of psychological variables such as depression and anxiety, as well as medication use, in mediating the pain–cognition relationship. The included studies displayed considerable methodological and clinical heterogeneity, particularly in pain types, participant characteristics, and cognitive assessments, which may explain the variability in findings and limit direct comparability. Conclusion: This review underscores the need to assess cognitive and psychosocial complications in individuals with chronic pain. Given the observed heterogeneity and variability in cognitive profiles, a multimodal and individualized approach to assessment and treatment is essential for effective chronic pain management.