Characterising the structure of cognitive hetereogenity in schizophrenia spectrum disorder: A systematic review and narrative synthesis

Philip J. Sumner, Tamsyn E. Van Rheenen, Caroline Gurvich, Philip J. Sumner, Susan L. Rossell

Research output: Contribution to journalReview ArticleResearchpeer-review

4 Citations (Scopus)


The aim of the present review was to systematically summarise our current understanding of the structure of the cognitive heterogeneity that exists within schizophrenia spectrum disorder (SSD). Fifty-two relevant studies were identified from January 1980 to March 2019 that investigated cognitive subgroups within SSD. Twenty-five studies employed classification criteria based on current neuropsychological function, 14 studies employed various data-driven subgrouping methodologies and 13 studies investigated putative cognitive symptom trajectories. Despite considerable methodological variability, three distinct cognitive subgroups reliability emerged; a relatively intact cognitive subgroup characterised by high cognitive performance, an intermediate cognitive subgroup defined by mixed or moderate levels of cognitive function/dysfunction and a globally impaired subgroup characterised by severe cognitive deficits. Whilst preliminary evidence suggests that these subgroups may have further investigative relevance in and of themselves, additional research is required and discussed. A set of reporting guidelines are also presented to overcome the methodological inconsistencies identified in the reviewed literature.

Original languageEnglish
Pages (from-to)252-278
Number of pages27
JournalNeuroscience and Biobehavioral Reviews
Publication statusPublished - 1 Dec 2019


  • Cluster
  • Cognition
  • Cognitive trajectory
  • Global impairment
  • Heterogeneity
  • Intelligence
  • Near-normal
  • Neuropsychology
  • Psychosis
  • Relatively intact
  • Schizoaffective disorder
  • Schizophrenia
  • Subgroup

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