Demographic and Clinical Correlates of Social Cognition in Schizophrenia: Observation from India

Abstract

Purpose: Although deficits in social cognition (SC) had been recognized as a hallmark of schizophrenia, quality data in Indian context were limited. The purpose of the current research was to determine the demographic and clinical correlates of SC in schizophrenia. Methods: Between February 2014 and January 2015, a case–control study was conducted in Chhattisgarh, India, among 100 paranoid schizophrenia patients (ICD-10) from two psychiatric hospitals and 100 neighborhood-based healthy (28-item General Health Questionnaire) controls. After obtaining signed consent, SC was assessed among 20–35-year-old, high school or more educated subjects ensuring eligibility for appropriate scales. Results: Patients had poorer social knowledge (adjusted-beta-coefficient [AC] = −4.89 [−6.32, −3.45]) and lower predicted mean score for internal attribution of negative event (AC: −0.72 [−1.17, −0.27]). Nonrecognition of facial expressions especially for anger (adjusted-odds-ratio [AOR] = 3.50 [1.17, 10.51]), surprise (AOR = 2.91 [1.36, 6.25]) and fear (AOR = 2.35 [1.11, 5.01]) was more common among cases. Wrong recognition of expressions was less likely among females (for surprise: AOR = 0.35 [0.13, 0.93]) and educated (for sadness: AOR = 0.11 [0.02, 0.58]) but more common among wealthy (for surprise: AOR = 4.58 [1.22, 17.19]) and urban (for fear: unadjusted odds ratios = 4.30 [1.53, 12.03]) subjects. If recognized expressions correctly, females were more likely to perceive higher intensity of anger (AOR = 4.30 [1.80, 10.29]) and happiness (AOR = 4.22 [1.66, 10.72]). Higher intensity was perceived by more educated subjects regarding anger (AOR = 2.57 [1.04, 6.34]) but not for happiness (AOR = 0.09 [0.01, 0.79]). Unmarried/divorced/separated perceived happiness (AOR = 2.86 [1.02, 7.97]) with more intensity while those in joint families perceived sadness (AOR = 2.80 [1.22, 6.41]) and fear (AOR = 2.28 [1.01, 5.16]) with more intensity. Conclusion: A significant impairment in SC was observed among paranoid schizophrenia cases in Chhattisgarh, India. Intervention and further research addressing identified issues of SC need to target specific subpopulations, among schizophrenia patients.

<p>Increased Plasma Kynurenic Acid Levels are Associated with Impaired Attention/Vigilance and Social Cognition in Patients with Schizophrenia</p>

“…Social cognitive impairment in SCZ has been reported in many studies. 55,56 Consistent with previous studies, our study found significant lower scores of social cognition assessed by the MCCB in SCZ patients than in healthy controls. We also found a correlation between plasma KYNA levels and social cognition in SCZ patients.…”

Development of the Delusional Interpretation Scale and examination of related variables

“… 2 Studies that investigated attributional tendencies in patients with schizophrenia have found that patients have a strong tendency toward external attribution. 33 , 34 The results of the factor analysis in this study contradict the results of previous research. This inconsistency may be because what was treated as “delusional thinking” in this study is a secondary delusion and also due to the characteristics of the sample.…”

“…Schizophrenia is a psychiatric disorder in which delusions are a major symptom 2 . Studies that investigated attributional tendencies in patients with schizophrenia have found that patients have a strong tendency toward external attribution 33,34 . The results of the factor analysis in this study contradict the results of previous research.…”

Pessimistic Attribution Style and other Attribution Styles in Anxiety Disorders: A Systematic Review

“…This phenomena is called self-serving bias and is universal 18 . Using attributional questionnaires, some researchers have identified exaggerated self-serving bias in schizophrenia spectrum [19][20][21][22] , whereas some researches could not replicate the finding [23][24][25] . One study reported AS in schizophrenia similar to depression 26 .…”