Metacognitive functioning is the basis of the individual’s ideas about his ability to build relationships with other people and manage own’s social behavior. Deterioration of metacognitive functioning in schizophrenia patients, presumably due to neurocognitive deficiency and other manifestations of the disease, probably contributes to disruptions of social functioning and quality of life. The aim of this study was to assess the metacognitive functioning (MF) of patients with paranoid schizophrenia, operationalized as a cognitive ability to understand their own and other people’s emotions, and to explore the connection between social functioning (SF) and quality of life (QOL), as well as to establish logical relationships between MF with clinical indicators and socio-demographic characteristics of patients. In a sample of 300 patients with paranoid schizophrenia (age from 18 to 50 years, disease duration of at least 5 years, a total PANSS score of less than 120), MF was assessed using the Lyusin emotional intelligence test (EmIn) and the subjective assessment of interpersonal relationships (SOMO) test. Cognitive deficit was verified using a standardized battery of a Brief Assessment of Cognition in Schizophrenia (BACS). The indicators obtained using the quality of life questionnaire for schizophrenia patients (QOL-SM) and the social functioning scale (PSP) were used to create an integrated indicator that comprehensively assesses SF and QOL of schizophrenia patients (Factor B). Reliable associations of this factor with indicators obtained using the Emin method (p<0.05), SOMO (p<0.001), the PSP scale, the QOL-SM questionnaire, the BACS and PANSS scales, and also with a number of clinical-dynamic and socio-demographic characteristics were established. Significant relationships between the parameters of MF, SF and QOL were obtained, and logical relationships between MF, neurocognitive deficiency and other clinical manifestations of schizophrenia were established.

The aim of the study was to develop a new valid psychometric diagnostic tool for a multi-factor social network assessment of schizophrenic patients, called «The structural assessment of the social network of schizophrenic patients». The new development is based on the social network analysis model elaborated by S. L. Phillips (1981) and translated into Russian by Gurovich I. Ya. et al. (2007). The authors of this article additionally developed an algorithm for assessing the activity of patients on social networks of the Internet. Reducing non-informative variables and conducting a confirmatory factor analysis in a sample of 265 observations of schizophrenic patients (F20.0) aged from 18 to 55, recruited in four medical organizations (145 patients admitted to the hospital and 55 outpatients), resulted in determining a four-factor structure of the patients’ social network: «Objective parameters», «Internet activity», «Emotional aspect of social support» and«Reciprocal support». The method has demonstrated high internal and external validity, as well as applicability in the clinical practice in schizophrenia due to the low resource consumption and compact applicability. Measurable factor indicators of the patients’ social networks obtained by using the structural assessment of the social network of schizophrenic patients allow to determine the targets for psychocorrectional interventions and to increase the effectiveness of psychosocial rehabilitation. In addition an automated method for calculating final indicators has been developed, as well as manual, practical recommendations and corresponding printed forms.

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The study considers the scientific views on the role of family relationships in the development and progress of schizophrenia, which have undergone a serious transformation during the last century. Earlier on, adepts of the psychoanalytic approach considered certain patterns of early interactions with the mother and significant others as a pathogen contributing to the development of schizophrenia in children, which caused stigmatization and significant distress of the patients’ relatives. According to the modern approach, close relatives of the patients are viewed firstly as people suffering in their situation and requiring psychological support, and secondly as one of the main factors defining the patient’s rehabilitation potential. The modern views refer to the fact that adequate family relationships can positively influence the opportunities of social adaptation of the patient, reduce the disease recurrence and contribute to an increased compliance. At the same time, negative relationships produce the opposite effect. Thus, examining the peculiarities of the patient’s family relations can be considered an undoubtedly important task, together with developing and implementing specialized psychosocial family interventions.