Anticipating DSM-V: opportunities and challenges for cognition and psychosis.

Asoutlinedby theBora article and commentary included in this issue of Schizophrenia Bulletin, the field has seen an increasing emphasis on the importance of cognition in understanding psychosis over the past 20 years. There is ample evidence that a large percentage of individuals with schizophrenia suffer from impairments in a range of cognitive domains, eg, Reichenberg et al, and growing evidence that the level of cognitive impairment predicts functional abilities in schizophrenia (social, occupational, and living status), eg, Heinrichs et al, Cervellione et al, McClure et al, and Green et al. As such, the hope is that by improving cognitive function among individuals with schizophrenia, we may be able to improve functional outcome in this very debilitating illness and thus improve the quality of life for individuals with schizophrenia and address important public health and humanitarian concerns. However, as noted by Bora and others, the question of how to incorporate conceptions of cognitive impairment into existing diagnostic criteria for schizophrenia and/orother psychotic disorders raises a challenging set of issues. Here, we outline what we think are some of the key issues in this regard and some potential pathways to address these challenges.