Negative symptoms and social cognition as mediators of the relationship between neurocognition and functional outcome in schizophrenia

被引:5
作者
Giordano, Giulia M. [1 ]
Pezzella, Pasquale [1 ]
Mucci, Armida [1 ]
Austin, Stephen F. [2 ]
Erfurth, Andreas [3 ]
Glenthoj, Birte [4 ,5 ,6 ]
Hofer, Alex [7 ]
Hubenak, Jan [8 ,9 ]
Libiger, Jan [8 ,9 ]
Melle, Ingrid [10 ,11 ]
Nielsen, Mette o. [4 ,5 ,6 ]
Rybakowski, Janusz K. [12 ]
Wojciak, Pawel [12 ]
Galderisi, Silvana [1 ]
Sachs, Gabriele [13 ]
机构
[1] Univ Campania Luigi Vanvitelli, Dept Psychiat, Naples, Italy
[2] Reg Zealand Psychiat, Psychiat Res Unit, Slagelse, Denmark
[3] Otto Wagner Spital, Psychiat Dept 6, Vienna, Austria
[4] Mental Hlth Ctr Glostrup, Ctr Neuropsychiat Schizophrenia Res CNSR, Glostrup, Denmark
[5] Mental Hlth Ctr Glostrup, Ctr Clin Intervent & Neuropsychiat Schizophrenia, Glostrup, Denmark
[6] Univ Copenhagen, Fac Hlth & Med Sci, Dept Clin Med, Copenhagen, Denmark
[7] Med Univ Innsbruck, Dept Psychiat Psychotherapy Psychosomat & Med Psy, Div Psychiat 1, Innsbruck, Austria
[8] Charles Univ Prague, Fac Med, Dept Psychiat, Hradec Kralove, Czech Republic
[9] Univ Hosp Hradec Kralove, Hradec Kralove, Czech Republic
[10] Univ Oslo, Inst Clin Psychiat, NORMENT Ctr, Oslo, Norway
[11] Oslo Univ Hosp, Oslo, Norway
[12] Poznan Univ Med Sci, Dept Adult Psychiat, Poznan, Poland
[13] Med Univ Vienna, Dept Psychiat & Psychotherapy, Vienna, Austria
来源
FRONTIERS IN PSYCHIATRY | 2024年 / 15卷
关键词
schizophrenia; negative symptoms; expressive deficit; motivational deficit; emotion recognition; processing speed; mediation analysis; FACIAL AFFECT RECOGNITION; CONTEXT-RELATED FACTORS; CLINICAL HIGH-RISK; PERSONAL RESOURCES; PROCESSING SPEED; EMOTION PERCEPTION; LIVED EXPERIENCE; SYNDROME SCALE; PSYCHOSIS; DEFICITS;
D O I
10.3389/fpsyt.2024.1333711
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Introduction In this study we assessed the contribution of psychopathology, including the two domains of negative symptoms (motivational deficit and expressive deficit), processing speed as an index of neurocognition, and emotion recognition, as an index of social cognition, to poor functional outcomes in people with schizophrenia.Methods The Positive and Negative Syndrome Scale was used to evaluate positive symptoms and disorganization and the Brief Negative Symptom Scale to assess negative symptoms. The Symbol Coding and the Trail Making Test A and B were used to rate processing speed and the Facial Emotion Identification Test to assess emotion recognition. Functional outcome was assessed with the Personal and Social Performance Scale (PSP). Regression analyses were performed to identify predictors of functional outcome. Mediation analyses was used to investigate whether social cognition and negative symptom domains fully or partially mediated the impact of processing speed on functional outcome.Results One hundred and fifty subjects from 8 different European centers were recruited. Our data showed that the expressive deficit predicted global functioning and together with motivational deficit fully mediated the effects of neurocognition on it. Motivational deficit was a predictor of personal and social functioning and fully mediated neurocognitive impairment effects on the same outcome. Both motivational deficit and neurocognitive impairment predicted socially useful activities, and the emotion recognition domain of social cognition partially mediated the impact of neurocognitive deficits on this outcome.Conclusions Our results indicate that pathways to functional outcomes are specific for different domains of real-life functioning and that negative symptoms and social cognition mediate the impact of neurocognitive deficits on different domains of functioning. Our results suggest that both negative symptoms and social cognition should be targeted by psychosocial interventions to enhance the functional impact of neurocognitive remediation.
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页数:14
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