Moderate Association Between Sociocognitive Functioning and Thought Disorder in Schizophrenia

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Interventions focused on emotion recognition may be effective in addressing sociocognitive deficits in patients with schizophrenia.

Data from a meta-analysis published in the British Journal of Psychiatry suggest that sociocognitive difficulties in patients with schizophrenia are strongly associated with thought disorder and disorganization.

Investigators performed a literature search across 3 electronic databases: PsycINFO, MEDLINE, and Web of Sciences. Peer-reviewed papers published between 1980 and 2016 were eligible for meta-analysis. Further, selected studies each included the following: a sample of patients with schizophrenia spectrum disorder, identifiable thought disorder or disorganization measures, identifiable sociocognitive measures, and available statistical data. These search criteria yielded 123 studies, among which 114 (92.7%) were cross-sectional and 9 (7.3%) were longitudinal.

The pooled study cohort was of mean age 36.6 (standard deviation 6.3) years. Participants were primarily men (69.6%). The pooled effect size for all literature was r =-0.313 (P <.001), suggesting a moderate association between social cognition and schizophrenia symptoms, although between-study heterogeneity was significant. Subsequent analyses were performed by symptom group: disorganization, alogia (poverty of speech), and thought disorder. A correlation of r =-0.323 was observed between disorganization and social cognition (P <.001). Similar correlations were observed between cognitive difficulties and alogia (r =-.300) and thought disorder (r =-.292) (both P <.001). In pooled analyses, moderate associations were observed between overall symptom severity and emotion recognition (r =-.334). Symptom severity had an additional moderate effect on theory of mind, or mental state attribution (r =-.349). Smaller effect sizes were identified between overall symptoms and social perception (r =-.188), emotion regulation (r =-.169), and attributional biases (r =-.143).

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Researchers noted the potential impact of publication bias on these results and cautioned against ready extrapolation. Additionally, as social cognition represents just 1 outcome domain, further research is necessary to identify the full spectrum of impairments associated with thought disorder and other symptoms of schizophrenia. However, these data suggest that interventions focused on emotion recognition may be effective in addressing sociocognitive deficits in patients with schizophrenia.


de Sousa P, Sellwood W, Griffiths M, Bentall RP. Disorganisation, thought disorder and socio-cognitive functioning in schizophrenia spectrum disorders [published online August 24, 2018]. Br J Psychiatry. doi:10.1192/bjp.2018.160