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Understanding the burden of cognitive impairment associated with schizophrenia: Results from the international LUCIA study
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DOI：10.1192/j.eurpsy.2026.12208.png)
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Abstract
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BackgroundCognitive impairment associated with schizophrenia (CIAS) is a prevalent; meaningful feature of schizophrenia with limited real-world data on its recognition and care setting impact. The LUCIA initiative is an international multi-stakeholder study that explored awareness; assessment practices; and the burden of CIAS to inform future care pathways.MethodsA three phase; Delphi-informed design was applied; comprising expert interviews to frame the enquiry; qualitative interviews with health and social care professionals (HCPs; n = 74) and caregiver advocates (n = 11); two waves of a Delphi survey among HCPs (n=449 and 343; respectively) and one round among 61 patients and 112 caregivers across 15 countries (n = 964).ResultsThe results showed poor awareness of CIAS across stakeholders. Structured cognitive assessment was infrequent; and clinicians largely relied on the dementia oriented Mini-Mental State Examination (MMSE) rather than schizophrenia specific tools; citing time; training; and unclear actionability as key barriers. CIAS imposed broad humanistic; clinical; societal; and economic burden – poorer quality of life; social isolation; higher comorbidities; increased hospital days and health care costs; and heavy informal care. Consensus actions prioritized the development of brief; validated screening instruments; improved psychoeducation; and accelerated research into effective pharmacological and non pharmacological interventions.ConclusionsThese results provide additional evidence for the under-recognition of CIAS worldwide; despite its substantial multidimensional societal burden. The use of dementia-oriented cognitive tests carries significant risks of misclassification and inappropriate management. Therefore; improving awareness; implementing assessment guidelines; and accelerating therapeutic innovation is critical to improve the quality of life of CIAS patients and the wider community.
Keywords:
burden
CIAS
cognitive impairment
Delphi
schizophrenia
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