Cognitive Impairment in Schizophrenia: Prevalence and Domain-Specific Deficits Among Indonesian Psychiatric Patients

Abstract

Background:  Cognitive impairment is a core dimension of schizophrenia that significantly contributes to long-term functional disability. Although international evidence indicates a high prevalence of cognitive deficits in schizophrenia, data regarding cognitive domain profiles among clinical populations in Indonesia remain limited. This Study aims to determine the prevalence of cognitive impairment and describe the profile of cognitive domain performance among patients with schizophrenia.

Methods:  This hospital-based cross-sectional study involved 101 patients with schizophrenia (ICD-10 F20) aged ≥18 years who were in clinically stable condition. Cognitive function was assessed using the Indonesian version of the Montreal Cognitive Assessment (MoCA-INA). Cognitive impairment was defined as a total MoCA score <26, with the standard education correction (+1 point for ≤12 years of education) applied. Descriptive analyses were conducted to present total and domain subscale scores as mean ± standard deviation and percentages of the maximum possible score for each domain.

Results: The mean age of respondents was 38.72 ± 9.22 years, with a mean duration of illness of 6.61 ± 3.86 years. The mean total MoCA score was 17.17 ± 7.02. Overall, 92.08% of patients had MoCA scores <26 (95% CI added: 87.20–96.96%) . Domain analysis showed the poorest performance in memory (delayed recall), achieving only 34.26% of the maximum score, followed by abstraction (43.07%) and attention (48.84%). Relatively preserved domains included naming (86.80%) and orientation (73.27%).

Conclusion: Cognitive impairment was detected in the majority of patients with schizophrenia at Aceh Psychiatric Hospital, with the most prominent deficits observed in memory and higher-order executive functions. These findings highlight the importance of integrating routine cognitive screening into the comprehensive management of patients with schizophrenia.