Features of neurocognitive deficit in schizophrenic and affective spectrum disorders with catatonic symptoms: a comparative study

Background. Modern neurobiological models link catatonia to disturbances in neurotransmitter systems and structural changes in the basal ganglia, accompanied by dysfunction of the prefrontal regions and specific cognitive impairments. In schiz-ophrenia and affective spectrum disorders, the severity of catatonic symptoms correlates with the depth of neurocognitive deficit. However, in this context, the significance of the psychopathological structure of disorders with catatonic symptoms, particularly the presence and severity of affective disorders, remains unclear. Meanwhile, affective disorders, such as depression, also trigger cognitive decline, and considering their mutual influence on neurocognitive deficits with catatonia can facilitate the optimization of treatment methods, rehabilitation, and prognosis assessment. Objective. To study the specific characteristics of neurocognitive deficit in schizophrenia and affective spectrum disorders with catatonic symptoms depending on the severity of affective (de-pressive) symptoms in the structure of a disease episode in comparison with a control group without catatonia and to identify nosological differences in the cognitive profile. Material and Methods. The study included 139 patients: 1) the main group (n=69) ‒ included patients with schizophrenia and affective spectrum disorders, including catatonic symptoms, divided into two subgroups: without pronounced affective symptoms (n=35) and with pronounced affective symptoms, mainly depressive (n=34), 2) a control group (n=70) with a comparable composition and similar division into subgroups. Diagnosis of catatonia was carried out using the Bush-Francis Catatonia Rating Scale (BFCRS), neurocognitive assessment was carried out using the BACS battery, MoCA and FAB scales. Statistical analysis included Bonferroni correction for multiple comparisons and multivariate analysis of variance (MANOVA). Results. Statistically significant differences were found between the groups in all cognitive domains (d=0.52-1.31, p<0.001), lower functional outcomes were found in the main group (PSP: 42.8±18.4 vs. 58.6±16.9, p<0.001). Two-way analysis revealed a statistically significant main effect of catatonia (F=31.2, p<0.001, η²=0.19), a moderate effect of affective disorders (F=12.4, p<0.01, η²=0.08) and their interaction (F=7.8, p<0.01, η²=0.05). The largest differences were ob-served in changes in psychomotor speed (F=26.7, p<0.001, η²=0.16), visuospatial functions (F=24.3, p<0.001, η²=0.15) and ex-ecutive functions (F=22.8, p<0.001, η²=0.14). Depressive symptoms increased cognitive deficits mainly in the domains of atten-tion and working memory. Correlation analysis revealed statistically significant (r=-0.68, p<0.001) relationships between the severity of catatonia on the BFCRS and the severity of cognitive impairment. Conclusion. Schizophrenia and affective spectrum disorders with catatonic symptoms are characterized by a specific profile of neurocognitive deficits with predominant involve-ment of the frontostriatal systems. Affective comorbidity modifies the cognitive profile, exacerbating attention and working memory impairments, which is important for planning differentiated rehabilitation programs.