Introduction

With psychiatric disorders affecting nearly one-half of American adults at some point in their lifetime, it is important to consider the impact psychopathological conditions may have on neuropsychological function; this is particularly true as individuals entering adulthood and later, old age, are often at greater risk for the development of psychopathological conditions. Whereas several adult psychopathological conditions may present with some form of cognitive inefficiency, the present discussion focuses on three disorders with relatively well-characterized neuropsychological profiles in adulthood and old age: schizophrenia, bipolar disorder, and major depression. What follows is a description of the pathophysiological mechanisms of these conditions, their most salient cognitive manifestations during adulthood and old age, assessment issues which may arise in neuropsychological evaluation of individuals with these disorders, and a review of the effects of treatment of these conditions on cognitive function.

Schizophrenia

Adulthood-onset schizophrenia is a psychiatric illness characterized by a constellation of symptoms that may include psychosis, thought disorder, disorganized behavior, and some form of negative symptomatology (e.g. alogia, affective flattening, or avolition). The prevalence of schizophrenia after 15 years of age is estimated to be between 2.7 and 8.3 per 1000 [1]. Whereas the peak incidence for males and females occurs between 15 and 24 years of age, females appear to have a second peak during the decade between the ages of 55 and 64 years. This later peak appears to counterbalance the higher prevalence of early-onset schizophrenia among males.