Negative symptoms and social cognition as mediators of the relationship between neurocognition and functional outcome in schizophrenia
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Negative symptoms and social cognition as mediators of the relationship between neurocognition and functional outcome in schizophrenia. / Giordano, Giulia M.; Pezzella, Pasquale; Mucci, Armida; Austin, Stephen F.; Erfurth, Andreas; Glenthøj, Birte; Hofer, Alex; Hubenak, Jan; Libiger, Jan; Melle, Ingrid; Nielsen, Mette; Rybakowski, Janusz K.; Wojciak, Pawel; Galderisi, Silvana; Sachs, Gabriele.
In: Frontiers in Psychiatry, Vol. 15, 1333711, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Negative symptoms and social cognition as mediators of the relationship between neurocognition and functional outcome in schizophrenia
AU - Giordano, Giulia M.
AU - Pezzella, Pasquale
AU - Mucci, Armida
AU - Austin, Stephen F.
AU - Erfurth, Andreas
AU - Glenthøj, Birte
AU - Hofer, Alex
AU - Hubenak, Jan
AU - Libiger, Jan
AU - Melle, Ingrid
AU - Nielsen, Mette
AU - Rybakowski, Janusz K.
AU - Wojciak, Pawel
AU - Galderisi, Silvana
AU - Sachs, Gabriele
N1 - Publisher Copyright: Copyright © 2024 Giordano, Pezzella, Mucci, Austin, Erfurth, Glenthøj, Hofer, Hubenak, Libiger, Melle, Nielsen, Rybakowski, Wojciak, Galderisi and Sachs.
PY - 2024
Y1 - 2024
N2 - 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.
AB - 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.
KW - emotion recognition
KW - expressive deficit
KW - mediation analysis
KW - motivational deficit
KW - negative symptoms
KW - processing speed
KW - schizophrenia
U2 - 10.3389/fpsyt.2024.1333711
DO - 10.3389/fpsyt.2024.1333711
M3 - Journal article
C2 - 38356912
AN - SCOPUS:85184907525
VL - 15
JO - Frontiers in Psychiatry
JF - Frontiers in Psychiatry
SN - 1664-0640
M1 - 1333711
ER -
ID: 384656672