Association of demographic characteristics, symptomatology, retrospective and prospective memory, executive functioning and intelligence with social functioning in schizophrenia

Objective: The objective of this study was to explore the influence of socio-demographic and clinical factors and neurocognitive variables (i.e. prospective and retrospective memory, executive functioning, and intelligence) on social functioning in Chinese schizophrenia patients. Methods: The study sample comprised 110 Chinese schizophrenia patients. Their clinical condition and social functioning were evaluated with the Brief Psychiatric Rating Scale (BPRS) and the Functional Needs Assessment (FNA), respectively. Three prospective memory (PM) tasks (time-, event-, and activity-based), three tests of executive functioning (the Design Fluency Test [DFT], Tower of London [TOL], and Wisconsin Card Sorting Test [WCST]), one test of intelligence (Raven's Progressive Matrices), and two retrospective memory (RM) tasks (the immediate and delayed recall conditions of the Logical Memory subtest of the Wechsler Memory Scales-Revised [WMS-R]) were administered to all patients. Results: In correlation analyses higher education and better performance on the WCST (categories completed) and the Logical Memory subtests (delayed and immediate) of the WMS-R are significantly correlated with better social functioning, whereas a lower WCST score (perseverative errors) and more severe negative symptoms are associated with poorer social functioning. Multiple linear regression analysis revealed that higher education and a lower WCST score (perseverative errors) independently contribute to better social functioning. Conclusions: Unexpectedly, most socio-demographic and clinical factors do not seem to have a significant impact on social functioning of Chinese schizophrenia patients living in a Chinese society. Negative symptoms and certain cognitive deficits were the main predictors of social functioning and they should be the main targets for antipsychotic treatment and psychosocial interventions to improve social adjustment in Chinese schizophrenia patients.