The role of neurocognitive deficits in understanding adaptive functioning in severe psychiatric illness: commentary on Hawkins and Cooper.

The presentation of Ms. E. by Hawkins and Cooper provides an excellent discussion of the diverse ways in which clinicians and clinical researchers are currently conceptualizing neurocognitive deficits within severe psychiatric disorders. The thorough neuropsychological evaluation of this patient provided a wealth of information that was completely missed by the Mini-Mental State Exam (MMSE; Folstein et al. 1975). As Hawkins and Cooper point out, the tendency of some clinicians to discount the role of neuropsychological deficiency in the face of adequate MMSE scores and evident psychiatric symptoms is not justified by the relevant clinical research literature. Furthermore, recent developments in scientific conceptions of the role of neurocognitive deficits in the more severe psychiatric disorders, such as schizophrenia, schizoaffective disorder, and bipolar mood disorder, deserve more attention in clinical practice.