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Psychology and Law
2026. Vol. 16, no. 1, 162–184
doi:10.17759/psylaw.2026160111
ISSN: 2222-5196 (online)

Attention dysfunction in psychoses associated with novel psychoactive substances: a comparison with schizophrenia

 
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Abstract

Context and relevance. Differentiating between endogenous and exogenous psychoses remains one of the most challenging tasks in contemporary psychiatry, as productive symptoms largely overlap and do not allow for a clear distinction. In this context, cognitive markers—particularly attention parameters—gain diagnostic importance, as they may reflect underlying differences in the mechanisms of psychosis formation. Objective is to provide a comparative analysis of the characteristics of attention in patients with acute psychoses induced by the use of NPS, and in patients with schizophrenia (F20). Hypothesis. Attention impairments in NPS-induced psychoses and schizophrenia differ across parameters: patients with schizophrenia are expected to demonstrate more stable and uniform decreases in attentional performance, whereas patients with NPS-psychoses are expected to show marked fluctuations in productivity, greater fatigability, and difficulties in attentional shifting. Materials and methods. The study included 133 inpatients of a psychiatric hospital: 72 with NPS-induced psychoses and 61 with schizophrenia (M = 31.3; SD = 7.57). Two standardized tools were employed to assess attentional functioning: the Symbol Coding subtest from the BACS battery, measuring processing speed and sustained attention, and the Schulte Tables, evaluating processing tempo, attentional shifting, and fatigability during serial task performance. Results. Significant differences were found between the groups. Patients with schizophrenia showed more pronounced deficits in sustained attention and overall processing efficiency. In contrast, patients with NPS-induced psychoses exhibited pronounced fluctuations in concentration, reduced attentional stability, and higher fatigability across serial tasks. Conclusions. The findings indicate qualitatively distinct mechanisms of attentional impairment in endogenous and exogenous psychoses. Schizophrenia is associated with a “rigid” type of deficit characterized by stable, uniform decline, while NPS-induced psychoses are marked by a “labile” type, including productivity fluctuations and rapid exhaustion. These distinctions hold diagnostic value for differentiating psychotic states and may inform the development of personalized cognitive remediation programs, as well as applications in forensic psychiatric evaluations where attentional control and behavioral regulation are under scrutiny.

General Information

Keywords: new psychoactive substances, acute psychosis, schizophrenia, attention deficits, attention

Journal rubric: Interdisciplinary Studies

Article type: scientific article

DOI: https://doi.org/10.17759/psylaw.2026160111

Received 29.04.2025

Revised 15.05.2025

Accepted

Published

For citation: Alekseev, I.A., Tkhostov, A.S., Shustov, A.D. (2026). Attention dysfunction in psychoses associated with novel psychoactive substances: a comparison with schizophrenia. Psychology and Law, 16(1), 162–184. (In Russ.). https://doi.org/10.17759/psylaw.2026160111

© Alekseev I.A., Tkhostov A.S., Shustov A.D., 2026

License: CC BY-NC 4.0

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Information About the Authors

Ilya A. Alekseev, Postgraduate Student at the Department of Neuro- and Pathopsychology, Faculty of Psychology, Lomonosov Moscow State University, Moscow, Russian Federation, ORCID: https://orcid.org/0009-0005-2538-4869, e-mail: alexseev97@mail.ru

Aleksandr S. Tkhostov, Doctor of Psychology, Professor, Professor, Head of Department of Clinical Psychology, Faculty of Psychology, Moscow State University Lomonosov, Leading researcher at the Mental Health Research Center of the Russian Academy of Medical Sciences, Moscow, Russian Federation, ORCID: https://orcid.org/0000-0001-9676-4096, e-mail: tkhostov@gmail.com

Alexander D. Shustov, Psychiatrist-Psychotherapist, Psychiatrist-Narcologist, Hospitalnaya 10, Moscow, Russian Federation, ORCID: https://orcid.org/0000-0003-4088-5109, e-mail: sashashustov777@mail.ru

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