scholarly journals Interplay among positive and negative symptoms, neurocognition, social cognition, and functional outcome in clinically stable patients with schizophrenia: a network analysis

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 1258
Author(s):  
Thammanard Charernboon
Keyword(s):  
Social Cognition ◽  
Network Analysis ◽  
Emotion Recognition ◽  
Functional Outcome ◽  
Negative Symptoms ◽  
Social Performance ◽  
Positive Symptoms ◽  
Impairment In Functioning ◽  
The Mind ◽  
Performance Scale

Background: Schizophrenia has a broad range of interrelated symptoms and impairment in functioning. The objective of the study was to explore the interplay between positive symptoms, negative symptoms, neurocognition, social cognition and functional outcome in patients with schizophrenia using network analysis. Methods: Participants were 64 clinically stable patients with schizophrenia. Psychopathologic, neurocognition, social cognition, and functional outcome were measured using the Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, Addenbrooke’s Cognitive Examination III, Faces test, Reading the Mind in the Eyes test, and Personal Social Performance scale. Results: The network analysis suggested that functional outcome was the most central in the network followed by avolition and asociality. Functioning was directly connected to avolition, asociality, blunted affect, neurocognition and emotion recognition. The positive symptoms were the most remote and therefore the least important node. Conclusion: The high centrality of functioning suggests the need for improving of everyday life skills for patients with schizophrenia. Moreover, treatment of specific negative symptoms, neurocognition and emotion recognition could also enhance functional outcome.

scholarly journals Improving Knowledge on Pathways to Functional Outcome in Schizophrenia: Main Results From the Italian Network for Research on Psychoses

2021 ◽  
Vol 12 ◽  
Author(s):  
Luigi Giuliani ◽  
Giulia Maria Giordano ◽  
Paola Bucci ◽  
Pasquale Pezzella ◽  
Francesco Brando ◽  
...  
Keyword(s):  
Social Cognition ◽  
Network Analysis ◽  
Everyday Life ◽  
Functional Outcome ◽  
Functional Capacity ◽  
Life Skills ◽  
Negative Symptoms ◽  
Cross Sectional ◽  
Follow Up Study

The identification of factors associated with functional outcome of subjects with schizophrenia is a great challenge in current research oriented to the personalization of care. The Italian Network for Research on Psychoses (NIRP) is a network of 26 university psychiatric clinics and/or mental health departments aimed to carry out multicenter research projects to improve the standards of prevention, diagnosis, and treatments of schizophrenia. The network has promoted 2 main studies, a cross-sectional one and a longitudinal one and seven “add-on” studies. The cross-sectional study of the network included 921 subjects with schizophrenia, 379 unaffected first-degree relatives of these patients, and 780 healthy controls. Results from this study documented that social and non-social cognition, functional capacity, negative symptoms, resilience, and family or social incentives strongly influence a measure of global functioning. The follow-up study included 618 patients from the original sample and has produced evidence of the key role of cognition, functional capacity, the experiential domain of negative symptoms, and everyday life skills in predicting functional outcome. The longitudinal study demonstrated that social cognition and the experiential domain of negative symptoms had an impact on interpersonal functioning, while non-social cognition had an impact on everyday life skills. Both non-social cognition and social cognition predicted work skills. The research question concerning the relationships of cognitive impairment and negative symptoms has been investigated with an innovative approach, using a structural equation model (SEM) and a network analysis. Both analyses demonstrated that only the experiential domain of negative symptoms had a distinct direct effect on functioning. The network analysis showed that expressive deficit was connected to functional capacity, as were social and non-social cognitive variables, and to disorganization. These findings were confirmed by the follow-up study. The add-on studies showed distinct electrophysiological correlates of the two negative symptom domains and the partial overlap between disorganization and neurocognitive impairment. Moreover, they identified and characterized a specific subgroup of patients suffering from schizophrenia with autism spectrum symptoms. The NIRP studies have implications for personalized management of patients with schizophrenia and highlight the need for a careful assessment of several domains rarely evaluated in clinical settings.

Clinical symptoms, mainly negative symptoms, mediate the influence of neurocognition and social cognition on functional outcome of schizophrenia

2013 ◽  
Vol 146 (1-3) ◽  
pp. 231-237 ◽  
Author(s):  
Chieh-Hsin Lin ◽  
Chieh-Liang Huang ◽  
Yue-Cune Chang ◽  
Po-Wei Chen ◽  
Chun-Yuan Lin ◽  
...  
Keyword(s):  
Social Cognition ◽  
Functional Outcome ◽  
Negative Symptoms ◽  
Clinical Symptoms

scholarly journals Sex Differences in Severity, Social Functioning, Adherence to Treatment, and Cognition of Adolescents with Schizophrenia

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Rodolfo Pérez-Garza ◽  
Gamaliel Victoria-Figueroa ◽  
Rosa Elena Ulloa-Flores
Keyword(s):  
Sex Differences ◽  
Social Functioning ◽  
Negative Symptoms ◽  
Clinical Presentation ◽  
Social Performance ◽  
Adherence To Treatment ◽  
Cognitive Improvement ◽  
Dsm Iv ◽  
Performance Scale ◽  
Positive And Negative Symptoms

Background.Previous studies have reported sex differences in the clinical presentation and outcome of adult patients with schizophrenia; the aim of present study was to compare the clinical characteristics, social functioning, adherence to treatment, and cognition of adolescents with this diagnosis in a six-month followup.Methods.A total of 87 adolescents with a DSM-IV diagnosis of schizophrenia or schizophreniform disorder were evaluated with the Positive and Negative Symptoms Scale (PANSS), the Matrics Consensus Cognitive Battery (MCCB), Personal and Social Performance Scale (PSP), and the Rating of Medication Influences (ROMI).Results.Both groups showed a similar improvement in all PANSS factors and in the PSP scores during the followup. Males better adhered to treatment. Females displayed better results in the area of social cognition (F=6.3, df = 2,52, andp=0.003) and attention/vigilance (F=8.3, df = 2,51, andp=0.001).Conclusions.Male and female adolescents showed similar clinical presentation and functioning but a different pattern of cognitive improvement and adherence to treatment. This trial is registered with Clinicaltrials.govII3/02/0811.‏

Social Cognition and Psychosocial Functioning in Schizophrenia

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
G. Juckel ◽  
M. Brüne
Keyword(s):  
Social Cognition ◽  
Theory Of Mind ◽  
Psychosocial Functioning ◽  
Social Performance ◽  
Anterior Cingulate ◽  
Healthy Controls ◽  
Significant Difference ◽  
Close Relationship ◽  
Functioning Level ◽  
Performance Scale

Ability for empathy and theory of mind are diminshed in patients with schizophrenia. These kinds of social cognition are, however, necessary to interact with other people and obtain a well-balanced psychosocial functioning level, i.e. to have friends, to go for work, to be in partnership and so on. Own studies revealed that disturbances in social cognition are accompanied by fMRI activation deficits in distinct regions of the underlying neuronanatomical loop in schizophrenia. The most significant difference compared to healthy controls was found in the region of the anterior cingulate cortex (ACC) and medial prefrontal cortex (mPFC). We think that training of social cognition would improve both the neurobiological hypoactivation and the ability for empathy and theory of mind. As consequence, psychosocial functioning of the patients should be become better as measured e.g. by the personal and social performance scale (PSP). To emphazise the close relationship between social cognition, ist underlying neuobiology and psychosocial functioning is the main purpose of this lecture.

FC19-05 - The importance of neurocognition, social cognition, negative symptoms and subjective process parameters for functional recovery in Schizophrenia

2011 ◽  
Vol 26 (S2) ◽  
pp. 1919-1919 ◽  
Author(s):  
S.J. Schmidt ◽  
D.R. Müller ◽  
V. Roder
Keyword(s):  
Quality Of Life ◽  
Social Cognition ◽  
Functional Outcome ◽  
Self Efficacy ◽  
Negative Symptoms ◽  
Longitudinal Design ◽  
Equation Modeling ◽  
List Type ◽  
Psychological Strain

BackgroundA wealth of research supports the relevance of neuro-, social cognition and negative symptoms as treatment targets in schizophrenia. However, little is known about their interdependent relationships, their relative contribution to adequate functioning and quality of life as well as their associations with subjective, process oriented variables.MethodsData were collected in the context of an international RCT evaluating the Integrated Neurocognitive Therapy (INT) in comparison to treatment as usual (TAU). 169 outpatients with a diagnosis of schizophrenia according to ICD-10 or DSM-IV-TR participated in the study. We chose a longitudinal design.First, by the means of structural equation modeling (SEM) we tested social cognition and negative symptoms as mediators between neurocognition and functional outcome. Additionally, the relationships of these variables with subjective parameters (hope, psychological strain, helplessness, initiative, knowledge about the disorder, insight, self-efficacy) were assessed. Second, we analyzed the same mediators and subjective variables but used quality of life instead of the traditional functional outcome measures.Results1.Social cognition and negative symptoms both served as mediators between neurocognition and functional outcome. Some subjective variables (e.g. hope) were associated with negative symptoms and functional outcome.2.Cognitive functions had no significant predictive or mediating influence on quality of life. Instead subjective variables (hope, psychological strain, self-efficacy) and negative symptoms functioned as significant predictors and were strongly related to each other.ConclusionsThe results of the study provide further evidence for integrated treatments. Including relevant subjective variables seems promising to generalize therapy effects to quality of life.

scholarly journals Aberrant effective connectivity is associated with positive symptoms in first-episode schizophrenia

2019 ◽  
Author(s):  
Martin J. Dietz ◽  
Yuan Zhou ◽  
Lotte Veddum ◽  
Christopher D. Frith ◽  
Vibeke F. Bliksted
Keyword(s):  
Social Cognition ◽  
Negative Symptoms ◽  
Effective Connectivity ◽  
Predictive Coding ◽  
First Episode ◽  
Positive Symptoms ◽  
Prediction Errors ◽  
Social Stimuli ◽  
Human Connectome Project ◽  
First Episode Schizophrenia

AbstractSchizophrenia is a tenacious psychiatric disorder thought to result from synaptic dysfunction. While symptomatology is traditionally divided into positive and negative symptoms, abnormal social cognition is now recognized a key component of schizophrenia. Nonetheless, we are still lacking a mechanistic understanding of how aberrant synaptic connectivity is expressed in schizophrenia during social perception and how it relates to positive and negative symptomatology. We used fMRI and dynamic causal modelling (DCM) to test for abnormalities in synaptic efficacy in twenty-four patients with first-episode schizophrenia (FES) compared to twenty-five matched controls performing the Human Connectome Project (HCP) social cognition paradigm. Patients had not received regular therapeutic antipsychotics, but were not completely drug naïve. Our data reveal an increase in excitatory feedforward connectivity from motion-sensitive V5 to posterior superior temporal sulcus (pSTS) in patients compared to matched controls. At the same time, were less accurate than controls in judging social stimuli from non-social stimuli. Crucially, patients with a higher degree of positive symptoms had more disinhibition within pSTS, a region computationally involved in Theory of Mind. We interpret these within a predictive coding framework where increased feedforward connectivity may encode aberrant prediction errors from V5 to hierarchically higher pSTS and local disinhibition within pSTS may reflect aberrant encoding of the precision of cortical representations about social stimuli.

scholarly journals Effectiveness of Integrated Neurocognitive Therapy on Cognitive Impairment and Functional Outcome for Schizophrenia Outpatients

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Andreana De Mare ◽  
Miriam Cantarella ◽  
Giovanni Galeoto
Keyword(s):  
Cognitive Impairment ◽  
Functional Outcome ◽  
Effect Size ◽  
Negative Symptoms ◽  
Social Cognitive ◽  
Meta Analysis ◽  
Positive Symptoms ◽  
Global Functioning ◽  
Cognitive Domains ◽  
Treatment Research

Cognitive impairment is highly prevalent in patients with schizophrenia and schizoaffective disorder. Many interventions have been developed to treat cognitive deficit, since it has a strong impact on functional outcome; however, there are no integrated interventions targeting multiple neuro- and social-cognitive domains with a particular focus on the generalization of the effects of therapy on the functional outcome. Recently, a group of experts has developed a cognitive remediation group therapy approach called Integrated Neurocognitive Therapy (INT), which includes exercises to improve the MATRICS (Measurement and Treatment Research to Improve Cognition in Schizophrenia) neuro- and social-cognitive domains. This systematic review and meta-analysis aimed to assess the efficacy of this approach. We conducted a search of PubMed, Scopus, Web of Science, and PsycINFO to select primary studies evaluating INT in schizophrenic and schizoaffective patients. The primary outcomes of the meta-analysis included negative and positive symptoms and global functioning. Two randomized controlled trials met inclusion criteria. A total of 217 participants were included. Based on the results from the Positive and Negative Syndrome Scale (PANSS), a significant pooled effect size was observed for negative symptoms, which demonstrated not only an improvement in the patients treated immediately after therapy but also a permanence of positive results at a 9–12-month follow-up. On the other hand, no significant effect size was observed for positive symptoms. In addition, a significant pooled effect size was found for Global Assessment of Functioning (GAF), which shows how INT’s integrated approach has lasting positive implications on patients’ functional outcome. We concluded that INT might be an effective treatment for negative symptoms and global functioning in patients with schizophrenia, compared to treatment as usual (TAU).

Neurocognitive Predictors of Social Cognition in Subjects with Schizophrenia and their First-degree Relatives

2017 ◽  
Vol 41 (S1) ◽  
pp. S40-S40 ◽  
Author(s):  
A. Mucci ◽  
S. Galderisi ◽  
P. Rocca ◽  
A. Rossi ◽  
A. Bertolino ◽  
...  
Keyword(s):  
Social Cognition ◽  
Functional Outcome ◽  
Functional Capacity ◽  
Structural Equation ◽  
Negative Symptoms ◽  
Mental States ◽  
Advisory Board ◽  
Small Sample ◽  
Equation Modeling ◽  
First Degree Relatives

IntroductionSocial cognition is a complex construct that refers to the functions required to understand other people's mental states and behavior. In people with schizophrenia, social cognition deficits account for a proportion of variance in functional outcome, independent of symptomatology. However, the relationships among social cognition, neurocognitive functioning and functional outcome are still unclear. Previous investigations had several limitations including small sample size, heterogeneous and limited measures of social cognition and neurocognitive functions.AimsWithin the study of the Italian Network for Research on Psychoses, we investigated factors influencing outcome in patients with schizophrenia and their unaffected relatives. Psychopathology, including depression, neurocognition, social cognition and outcome were assessed using instruments designed to overcome some of the previous limitations.MethodsStructural equation modeling was used to test direct and indirect effects of neurocognition, social cognition and functional capacity on vocational and interpersonal functioning. Tests of facial emotion recognition, emotional intelligence and theory of mind were included to assess social cognition. The MATRICS Consensus Cognitive Battery (MCCB) was used to investigate neurocognition.ResultsIn both subjects with schizophrenia and their first-degree relatives, social cognition was found to be independent of negative symptoms and to have a direct impact on outcome. Neurocognition was a predictor of functional capacity and social cognition, which both mediated its impact on outcome. Social cognition was independent of functional capacity and negative symptoms.ConclusionsBetter understanding of how neurocognitive dysfunction and social cognition deficits relate to one another may guide efforts toward targeted treatment approaches.Disclosure of interestAM received honoraria or advisory board/consulting fees from the following companies: Janssen Pharmaceuticals, Otsuka, Pfizer and Pierre Fabre SG received honoraria or advisory board/consulting fees from the following companies: Lundbeck, Janssen Pharmaceuticals, Hoffman-La Roche, Angelini-Acraf, Otsuka, Pierre Fabre and Gedeon-Richter.All other Authors declare no potential conflict of interest.

scholarly journals Negative and Neutral Valences of Affective Theory of Mind are More Impaired than Positive Valence in Clinically Stable Schizophrenia Patients

2020 ◽  
Vol 17 (5) ◽  
pp. 460-464
Author(s):  
Thammanard Charernboon
Keyword(s):  
Social Cognition ◽  
Theory Of Mind ◽  
Emotion Recognition ◽  
Mental State ◽  
Emotional Valence ◽  
Positive Valence ◽  
The Mind ◽  
Normal Controls

Objective People with schizophrenia show impairment in social cognition, such as emotion recognition and theory of mind. The current study aims to compare the ability of clinically stable schizophrenia patients to decode the positive, negative and neutral affective mental state of others with educational match-paired normal control.Methods 50 people with schizophrenia and 50 matched controls were compared on the positive, negative and neutral emotional valence of affective theory of mind using the Reading the Mind in the Eyes Tests.Results The results showed that people with schizophrenia performed worse in negative and neutral emotional valence than normal controls; however, no significant differences in decoding positive valence were found.Conclusion Our data suggest that there is variability in the performance of affective theory of mind according to emotion valence; the impairments seem to be specific to only negative and neutral emotions, but not positive ones.

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