medjournalМедицинский журналMedical Journal1818-426XБелорусский государственный медицинский университет10.51922/1818-426X.2026.4.33medjournal-470Research ArticleОБЗОРЫREVIEWSКогнитивный дефицит при расстройствах шизофренического спектра: современное состояние проблемыCOGNITIVE DEFICITS IN SCHIZOPHRENIA: CURRENT STATE OF THE PROBLEMЖуковаД. И.ZhukovaD. I.

Санкт-Петербург

Saint Petersburg

ИгумновС. А.IgumnovS. A.

Москва

Moscow

БутурлинН. А.ButurlinN. A.

Москва

Moscow

Санкт-Петербургский университет МВД РоссииРоссияSaint Petersburg University of the Ministry of Internal Affairs of RussiaRussian FederationИнститут нейронаук и нейротехнологий Российского национального исследовательского медицинского университета имени Н.И. Пирогова Минздрава РоссииРоссияInstitute of Neurosciences and Neurotechnologies of the Russian National Research Medical University named after N.I. Pirogov of the Ministry of Health of RussiaRussian FederationООО «Госпитальная 10»РоссияHospitalnaya 10 LLCRussian Federation202627102026043339Copyright © Жукова Д.И., Игумнов С.А., Бутурлин Н.А., 20262026Жукова Д.И., Игумнов С.А., Бутурлин Н.А.Zhukova D.I., Igumnov S.A., Buturlin N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medjournal.ejournal.by/jour/article/view/470

Нарушения когнитивных функций при расстройствах шизофренического спектра представляют собой центральный, а зачастую и определяющий элемент в структуре расстройств шизофренического спектра, напрямую влияя на способность пациентов к социальному и профессиональному функционированию. Целью данной работы стал комплексный анализ актуальных научных представлений о природе, диагностике и коррекции когнитивного дефицита в рамках расстройств шизофренического спектра. В основе данного исследования лежит теоретический анализ отечественных и зарубежных публикаций, включая систематические обзоры, мета-анализы и клинические рекомендации за период 2012–2025 годов. Результаты показывают, что когнитивные нарушения отличаются высокой распространенностью (75–85 % пациентов) и значительной гетерогенностью. На сегодняшний день обосновано выделение четырех основных когнитивных подтипов: с глобальным дефицитом когнитивных функций (25–30 %), с изолированным нарушением исполнительных функций (25–35 %), со снижением скорости обработки информации (20–30 %) и с минимальными нарушениями когнитивных функций (15–25 %). В качестве «золотого стандарта» для их объективной оценки уровня нарушения когнитивных функций при расстройствах шизофренического спектра обычно рассматривается батарея MATRICS Consensus Cognitive Battery (MCCB). Среди методов коррекции наиболее доказанной эффективностью обладает когнитивная ремедиация, демонстрирующая устойчивый, хотя и умеренный, положительный эффект. В заключении данной статьи подчеркивается необходимость перехода к персонализированным стратегиям реабилитации, которые бы интегрировали традиции отечественной патопсихологии с современными международными диагностическими и терапевтическими стандартами.

Cognitive impairments in schizophrenia spectrum disorders are a central and often defining element in the structure of schizophrenia spectrum disorders, directly affecting patients’ ability to social and professional functioning. The purpose of this work was a comprehensive analysis of current scientific ideas about the nature, diagnosis and correction of cognitive deficit within the framework of schizophrenia spectrum disorders. This study is based on a theoretical analysis of domestic and foreign publications, including systematic reviews, meta-analyses and clinical guidelines for the period 2012–2025. The results show that cognitive impairments are highly prevalent (75–85 % of patients) and significantly heterogeneous. To date, four main cognitive subtypes have been identified: those with global cognitive deficits (25–30 %), those with isolated executive dysfunction (25–35 %), those with reduced information processing speed (20–30 %), and those with minimal cognitive impairments (15–25 %). The MATRICS Consensus Cognitive Battery (MCCB) is commonly used as a “gold standard” for objectively assessing cognitive impairment in schizophrenia spectrum disorders. Among the treatment methods, cognitive remediation has the most proven effectiveness, demonstrating a consistent, albeit moderate, positive impact. In conclusion, this article emphasizes the need to transition to personalized rehabilitation strategies that integrate the traditions of Russian pathopsychology with modern international diagnostic and therapeutic standards.

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The authors declare that there are no conflicts of interest present.