Neuropsychological profiles in long-term schizophrenia: A cluster analysis

This study examines neurocognitive heterogeneity in a large, predominantly chronic and institutionalized sample of individuals with schizophrenia (N = 184). Using hierarchical and iterative clustering on composite neuropsychological scores, four distinct cognitive profiles emerged: Severe Cognitive Impairment, Cognitive Impairment, Preserved Cognition, and a small High Functioning subgroup. Impaired profiles were the most prevalent, reflecting the long illness duration and institutional context of the sample. Despite this, a subset of participants demonstrated above average performance, suggesting the presence of resilience related factors such as cognitive reserve. Robust differences across clusters were observed in all cognitive domains, supporting the existence of discrete neurocognitive subtypes rather than a single severity continuum. These findings highlight the relevance of cognitive stratification in chronic schizophrenia and underscore the need for individualized interventions tailored to specific cognitive profiles within institutionalized settings.