Cognitive Impairment Associated With Schizophrenia: Social Media Discussions Reveal the Most Burdensome Cognitive Symptoms and Challenges Related to Social Stigma and Isolation

Introduction: An artificial intelligence–based semantic analysis of social media posts was carried out to reveal the burden of cognitive symptoms on the daily lives of people with schizophrenia.

Methods: Posts from 23 online health communities across 4 languages (English, Japanese, Chinese, German) were retrieved (August 2020–July 2024). People’s experiences were detected using a generative artificial intelligence–based tool and analyzed using Natural Language Processing.

Results: Overall, 263,046 posts from 8219 unique people with schizophrenia were collected. People who mentioned symptoms (n=5251/8219, 64%) mentioned cognitive and negative symptoms less (collectively, ~30%) compared with positive symptoms (98%). However, cognitive and negative symptoms were perceived as equally burdensome with a “high severity” rating in 27% and 25% of mentions, respectively, compared with 33% for positive symptoms. The cognitive symptoms most frequently mentioned by people were thinking problems (25% of all cognitive symptoms), general cognitive challenges (16%), forgetfulness (15%), memory deficit (14%), and irrationality (13%). People with cognitive symptoms also reported challenges regarding decision making, and verbal and communication issues: "...when I'm stressed, I repeat the words of others...”. Due to challenges with cognitive symptoms, and a lack of societal understanding about schizophrenia, people reported difficulties with stigma and isolation: “People just don’t get how hard it is.”

Conclusions: Cognitive symptoms in people with schizophrenia are burdensome and may contribute to stigmatization and social isolation. Findings were consistent with current literature describing schizophrenia as being associated with substantial cognitive impairment in addition to psychosis.

Funding: Boehringer Ingelheim.