Prevalence and risk factors for different levels of cognitive impairment in schizophrenia patients with suicidal ideation

Schizophrenia is associated with a substantially elevated lifetime risk of suicide. Although cognitive impairment has been widely recognized as a core clinical feature of this disorder, the relationship between cognitive dysfunction and suicidal ideation (SI) remains inadequately understood. The present study investigated the prevalence of cognitive impairment and explored its associated risk factors among patients with schizophrenia who reported SI. A total of 812 participants were enrolled in the study. Suicidal ideation was evaluated using the Beck Scale for Suicide Ideation (BSS), while cognitive functioning was assessed with the Mini-Mental State Examination (MMSE) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Based on the BSS cutoff criteria, 172 patients were classified as having SI. Among these individuals, the prevalence of cognitive impairment, as defined by MMSE scores, was 54.7%, which was significantly lower than that observed in patients without SI. Further comprehensive neuropsychological evaluation using the RBANS provided a more detailed characterization of cognitive performance across multiple cognitive domains. Cognitive impairment was found to be common among patients with schizophrenia and SI, although its prevalence was lower than that in patients without SI. Age and level of educational attainment emerged as important factors associated with cognitive outcomes, highlighting their relevance for understanding and addressing cognitive deficits in this high-risk population.