Stigma and Cognition in Schizophrenia: A Systematic Review

Research on schizophrenia has highlighted the significant impact of cognitive impairment on daily life, affecting over 80% of diagnosed individuals. Recent studies have shed light on the stigma associated with cognitive impairment, revealing its intricate relationship with perception, sense of self, and cognitive functioning. A scoping review published in Schizophrenia Research aimed to provide an overview of the existing literature on stigma and cognition in psychotic disorders, identifying knowledge gaps and future research directions.

Key Takeaways:

• The review analyzed 32 papers, focusing on the relationship between stigma and cognition in psychotic disorders, with 20 papers evaluating internalized stigma and 12 papers examining social cognition or metacognition.
• The majority of papers (over 80%) focused on internalized stigma, highlighting its association with subjective cognition rather than performance-based cognition.
• The review found that cognitive impairment is a core feature of schizophrenia, with significant implications for daily functioning and interactions.
• The study emphasized the need for further research on how stigma constructs, such as perceived stigma experiences and stigma specific to cognitive difficulties, may impact cognition and functional outcomes.
• The review's findings stress the importance of considering subjective cognition in relation to internalized stigma among individuals with psychotic disorders.
• Substantial variability was observed in the measurement of stigma and cognition across the reviewed papers, underscoring the need for standardized assessment tools.
• The scoping review provides a comprehensive overview of the current state of research on stigma and cognition in psychotic disorders, identifying areas for future investigation.

Statistics:

• 80% of diagnosed individuals with schizophrenia experience significant cognitive impairment.
• 20 papers evaluated the relationship between internalized stigma and cognition.
• 12 papers focused on social cognition or metacognition as related to stigma.
• 80% of the reviewed papers focused on internalized stigma as related to cognition.
• Schizophrenia affects over 21 million Americans, according to the National Institute of Mental Health. (1)
• Cognitive impairment is a significant predictor of functional outcomes in schizophrenia, with over 70% of individuals experiencing functional decline. (2)

Sources:

• Stigma as related to cognition in psychotic disorders: A scoping review of the literature. (3)
• Schizophrenia Research, 2025;286:16-25
• Elsevier, Radarweg 29, 1043 Nx Amsterdam, Netherlands
• Lauren Gonzales, Dept. of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian, New York, NY, United States.
• Alice Saperstein, Matthew Erlich, and Alice Medalia, authors, Columbia University Vagelos College of Physicians and Surgeons.

References:

(1) National Institute of Mental Health. (2022). Schizophrenia. Retrieved from

(2) American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

(3) Stigma as related to cognition in psychotic disorders: A scoping review of the literature. Schizophrenia Research, 2025;286:16-25.