An in-depth investigation spearheaded by renowned researchers in the field of psychiatry has provided significant insights into the influence of cognitive reserve (CR) on individuals suffering from psychosis and schizophrenia. The groundbreaking study, recently published in the Spanish Journal of Psychiatry and Mental Health, has shone a light on the diverse effects of CR during different stages of these mental health conditions.

Cognitive reserve — the brain’s resilience to neuropathological damage — has long been considered a crucial factor in determining the prognosis of mental health disorders. The Spanish researchers aimed to discern how CR levels impact clinical, neurocognitive, and lifestyle outcomes among patients at the early stage of psychosis (ESP) and in those with chronic schizophrenia (SCZ).

The study observed a sample size that included 60 patients at the ESP and 225 with SCZ. A meticulous analysis leveraging logistic regression helped the research team to explore the predictive capacity of CR within each diagnostic group. Hierarchical linear regression analyses were deployed to delve deeper into the associations between CR and various outcomes, while mediation analyses followed the established principles of Baron and Kenny.

The most striking revelation was that patients with SCZ displayed significantly lower cognitive reserves compared to their counterparts at the ESP. When CR was quantitively measured, it was found to correctly classify a substantial 79.6% of the cases, thereby reinforcing its predictive reliability for these mental health conditions.

In patients at the early stages of psychosis, CR was associated with crucial aspects such as working memory and the presence of negative symptoms. Moreover, the study illuminated the connection between CR and general functioning, finding that CR and lifestyle factors such as cannabis use accounted for 26.7% of the variance in functional outcomes in ESP patients.

In the more chronically afflicted SCZ group, CR showed a noteworthy predictive ability across all cognitive domains, painting a worrisome picture for those with diminished cognitive reserve. Here, the tie between CR and negative symptoms was notably strong.

The study was led by an esteemed group of professionals, including Silvia S. Amoretti and Gerard G. Anmella from the Group of Psychiatry, Mental Health and Addictions, Vall d’Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain, along with their collaborator Miquel M. Bernardo from Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona, and several others from associated institutions.

The findings underscore that cognitive reserve’s impact is heavily dependent on the disease’s stage — ESP vs. SCZ. This implies that there’s a greater need to focus on enhancing CR to potentially improve neurocognition and reduce negative symptoms, especially in patients with chronic schizophrenia.

The research has been universally heralded as a stepping stone on the path to better understanding and managing the complexities of psychosis and schizophrenia. Specialists in the field posit that this study could pave the way for tailor-made therapies that target the enhancement of cognitive reserves, thus potentially improving the overall quality of life and clinical outcomes for affected individuals.

The study, “Impact of cognitive reserve in clinical, neurocognitive and lifestyle factors in patients with the first-episode of psychosis and schizophrenia,” has been made available for the wider medical community with its DOI: 10.1016/j.sjpmh.2024.01.003, shining as a beacon for future research.

The research is particularly significant as it underscores the potential of cognitive reserve to serve as a protective factor in clinical treatments. With its detailed empirical evidence and comprehensive analyses, it is a seminal paper that will likely spur a range of follow-up studies seeking to corroborate and expand upon these findings.

For further insights and perspectives on this study, the following references have been integral in shaping the understanding of cognitive reserve and its impact on psychiatric disorders:

1. Stern, Y. (2002). What is cognitive reserve? Theory and research application of the reserve concept. Journal of the International Neuropsychological Society, 8(3), 448–460.
2. Barnett, J. H., Salmond, C. H., Jones, P. B., & Sahakian, B. J. (2006). Cognitive reserve in neuropsychiatry. Psychological Medicine, 36(8), 1053–1064.
3. Katz, M. J., Lipton, R. B., Hall, C. B., Zimmerman, M. E., Sanders, A. E., Verghese, J., … & Derby, C. A. (2012). Age and sex-specific prevalence and incidence of mild cognitive impairment, dementia, and Alzheimer disease in blacks and whites: a report from the Einstein Aging Study. Alzheimer Disease & Associated Disorders, 26(4), 335.
4. Valenzuela, M. J., & Sachdev, P. (2006). Brain reserve and dementia: a systematic review. Psychological Medicine, 36(4), 441–454.
5. Le Carret, N., Lafont, S., Mayo, W., & Fabrigoule, C. (2003). The effect of education on cognitive performances and its implication for the constitution of the cognitive reserve. Developmental Neuropsychology, 23(3), 317-337.


1. Cognitive Reserve
2. Schizophrenia Research
3. Psychosis Treatment
4. Negative Symptoms
5. Neurocognition in Mental Health