Functional cognitive disorder (FCD) is characterised by persistent subjective cognitive complaints that cannot be adequately explained by objectively demonstrable organic pathology. A core feature of the disorder is internal inconsistency, which can manifest as a discrepancy between a high level of subjectively perceived cognitive difficulties and relatively preserved objective cognitive functioning. However, this discrepancy has so far been described primarily in qualitative terms and has received little direct empirical investigation. The present study aimed to compare subjective and objective cognitive functioning in individuals with FCD and healthy controls and to directly quantify the discrepancy between these measures. Given the potential contribution of psychological factors to the development and maintenance of FCD, we additionally examined the role of perfectionism and rumination. The study included 21 individuals with FCD and 30 healthy controls aged 49 to 80 years (M = 64.76; SD = 9.26). Participants underwent an individual neuropsychological assessment comprising measures of memory, attention, executive functions, and language and completed questionnaires assessing subjective cognitive difficulties, perfectionism and rumination. Results showed that individuals with FCD reported significantly more pronounced subjective cognitive difficulties, whereas the groups did not differ significantly in objective cognitive functioning. Calculation of the subjective–objective cognitive discrepancy index showed a significantly greater discrepancy in individuals with FCD compared with the reference value of the control group. Perfectionism and rumination did not differ significantly between the groups and were not significantly associated with cognitive functioning in individuals with FCD. The findings support the presence of internal inconsistency between subjective and objective measures of cognitive functioning in individuals with FCD. Direct quantification of this discrepancy represents a novel approach to the empirical investigation of internal inconsistency in FCD and provides a basis for further research into factors that contribute to its development and maintenance.
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