Social Cognition in Schizophrenia, Part 2: 12-Month Stability and Prediction of Functional Outcome in First-Episode Patients
Social Cognition in Schizophrenia, Part 2: 12-Month Stability and Prediction of Functional Outcome in First-Episode Patients
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DOI：
10.1093/schbul/sbr001
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发表时间：
2012-06-01
影响因子：
6.6
通讯作者：
Nuechterlein, Keith H.
中科院分区：
文献类型：
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作者：
Horan, William P.;Green, Michael F.;Nuechterlein, Keith H.
本研究评估了精神分裂症早期社会认知的纵向稳定性和功能相关性。55名首发精神分裂症患者完成了对社会认知的三个关键领域(情绪处理、心理理论和社会/关系知觉)的基线评估和12个月的随访评估，以及对现实世界功能和症状的临床评级。3项社会认知测验均显示出较好的纵向稳定性，重测相关均在0.70以上。在12个月的跟踪评估中，较高的基线和12个月的社会认知得分都与显著改善的工作功能、独立生活和社会功能密切相关。此外，交叉滞后的小组分析与一个因果模型是一致的，在该模型中，基线社会认知在工作领域推动后来的功能结果，超过了症状的贡献。社会认知障碍是早期精神分裂症相对稳定、功能相关的特征。这些结果扩展了一项配套研究的发现，该研究显示，在相同的衡量标准下，疾病的前驱、首发和慢性阶段的患者都有稳定的损害。社会认知障碍可作为有用的易损性指标和早期临床干预靶点。
This study evaluated the longitudinal stability and functional correlates of social cognition during the early course of schizophrenia. Fifty-five first-episode schizophrenia patients completed baseline and 12-month follow-up assessments of 3 key domains of social cognition (emotional processing, theory of mind, and social/relationship perception), as well as clinical ratings of real-world functioning and symptoms. Scores on all 3 social cognitive tests demonstrated good longitudinal stability with test-retest correlations exceeding .70. Higher baseline and 12-month social cognition scores were both robustly associated with significantly better work functioning, independent living, and social functioning at the 12-month follow-up assessment. Furthermore, cross-lagged panel analyses were consistent with a causal model in which baseline social cognition drove later functional outcome in the domain of work, above and beyond the contribution of symptoms. Social cognitive impairments are relatively stable, functionally relevant features of early schizophrenia. These results extend findings from a companion study, which showed stable impairments across patients in prodromal, first-episode, and chronic phases of illness on the same measures. Social cognitive impairments may serve as useful vulnerability indicators and early clinical intervention targets.