Consummatory Social Pleasure Reduced in Schizophrenia

A systematic review and meta-analysis published in Schizophrenia Bulletin found that people with schizophrenia had reduced consummatory social pleasure compared with the general population.

Investigators from Indiana University-Purdue University searched publication databases from 1997 through November 2021 for studies evaluating the emotion paradox extended to social situations in schizophrenia.

A total of 26 samples were included in this study, which were peer-reviewed publications (n=25) and 1 poster presented at an international conference, published or presented between 1997 and 2021. The studies were conducted in the United States (n=11), the United Kingdom (n=4), the Netherlands (n=4), Germany (n=3), France (n=2), and South Korea (n=2).

The total sample size was 929 patients with psychotic disorders and 953 controls. The participants were generally well matched, had a mean age of 36.8 years, and 63% were men.

Patients with schizophrenia and controls differed significantly in consummatory social pleasure (Hedge’s g, -0.38; P <.001), in which patients with psychotic disorders reported less pleasure than controls. After removing 4 outliers, the association remained significant (g, -0.36; P <.001). These comparisons had significant heterogeneity (I², 73.71%; P <.001).

Significant moderation effects were observed for study design (Q, 5.46; P =.02), in which between-study variability was observed in studies using experience sampling methods (Q, 59.45; P <.001) but not in laboratory studies (Q, 15.21; P =.173). Stratified by directness of effects, significant indirect effects of pleasure measures were observed (g, -0.68; P <.001) whereas direct measures only trended toward significance (g, -0.20; P =.06).

No clinical characteristics were observed to modify the observed effects (P >.05).

The findings of this analysis may not be generalizable for all patients with schizophrenia, as most studies recruited stable individuals from the outpatient setting.

Study authors concluded, “These results have important implications for treating social dysfunction in schizophrenia. […] [L]arger deficits in social pleasure found in [experience sampling method] studies may be due to differences in the nature of social interactions people with schizophrenia engage in during daily life. Thus, interventions should not only teach social skills, but also address real-world barriers to participating in higher-quality social experiences to lessen this social pleasure gap.”