Subjective experiences of cognitive functioning in early psychosis: a qualitative study

Background: Cognitive deficits are a risk factor for psychosis onset and are associated with poorer clinical and functional outcomes. Few studies, however, have examined the lived experience of these impairments, particularly in people with emerging psychosis. This qualitative study explored how individuals with early psychosis experienced cognitive functioning and its relationship with psychosocial functioning.Methods: Ten participants, aged 18 to 25, were recruited from an early psychosis assessment and treatment service. Data were collected using a semi-structured interview and analyzed using thematic analysis. The results revealed five overarching themes: 1) Cognitive Impairments; 2) Impact of Cognitive Impairment on Functioning; 3) Impact of Cognitive Impairments on Self-Concept; 4) Relationship between Cognitive Impairments and Treatment; 5) Cognitive Impairments – Helpers and Hindrances.Results: Cognitive deficits were experienced as pervasive in early psychosis, negatively affecting everyday functioning and self-concept, yet were not a perceived barrier to psychological management. There was both a perceived need for and an awareness of therapeutic interventions and lifestyle changes that may help alleviate cognitive difficulties.Conclusions: Subjective cognitive impairments are disruptive in early psychosis and should be routinely investigated in treatment. Cognitive remediation, compensation and lifestyle modifications may be ideal methods of supporting cognitive function in individuals with early psychosis.