Cognitive Deficits and Social Functioning in Schizophrenia: A Clinical Perspective

Abstract

Impaired social functioning is one of the diagnostic features of schizophrenia. Cognitive functioning is also often impaired in several domains. Meta-analysis has shown a predictive value of cognition for a variety of domains related to social functioning (Green, Kern, Braff, & Mintz, 2000). The significance of these findings for clinical practice has remained largely uninvestigated, however, and is therefore taken up here. We investigated verbal memory, attention and executive functioning in 52 schizophrenia patients. Social functioning was assessed for different types of social roles. The percentages of cognitive and social impairments in our group were assessed according to clinical principles, normally used to judge an individual patient. A possible predictive relationship between cognition and social functioning was studied on the basis of these clinical criteria. A large proportion of patients showed impairments in both cognitive functioning and social functioning. However, the clinical method resulted in a successful prediction of social functioning in only 21-69% of the cases. Social functioning and cognitive functioning were impaired in a large proportion of patients, but were largely independent from each other. Since relationships between cognition and social functioning are weak, assessment procedures are inconsistent and possibly not optimally adjusted to the psychiatric population, the clinical relevance of cognitive testing in order to predict social functioning is as yet questionable.

The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: A meta-analysis

“…Overall, 87% were diagnosed with schizophrenia, 12% with schizoaffective disorder and 1% had other diagnoses in the non-affective psychosis spectrum. Five articles included samples of patients with schizophrenia or schizoaffective disorder but did not report exact numbers (Corrigan and Toomey, 1995;Meyer and Kurtz, 2009;Nakagami et al, 2008;Van Beilen et al, 2003;Velligan et al, 2004). The sample included 76.1% outpatients.…”

Factors associated with functional psychosocial status in first‐episode psychosis

“…3,4 van Beilen and colleagues concluded that the domains of psychosocial functioning and neuropsychological functioning at the same time point are largely independent of one another. 29 However, it is worth noting that they used self-rated measures of social functioning, which might have influenced their results depending on the insight of the participants. Moreover, all of the above studies relate to persons with chronic schizophrenia, rather than those in the early phases of a psychotic illness.…”

“…'s reviews have generally concluded that neurocognitive measures have a stronger relationship with function than negative or positive symptoms, albeit based mainly on correlational studies 3,4 . van Beilen and colleagues concluded that the domains of psychosocial functioning and neuropsychological functioning at the same time point are largely independent of one another 29 . However, it is worth noting that they used self‐rated measures of social functioning, which might have influenced their results depending on the insight of the participants.…”

Predictors of social cognition in patients with schizophrenia

“…Although it seems obvious that social cognition could depend and interact with cognitive and community functioning, few attempts towards an integration of theory and findings have been made (van Beilen et al 2003). In this study we attempted to integrate the areas of neurocognition, clinical symptomatology, and community functioning, as well as sociodemographic variables in order to evaluate their ability to predict social reasoning.…”