Social Cognition Among a Sample of Patients with Schizophrenia

Abstract

SUMMARY S chizophrenia is a severe and persistent mental disorder that places significant burden on the individuals who suffer from it, as well as their families and society. The illness is defined by the presence of positive (i.e., hallucinations, delusions, disorganized thinking) and negative (i.e., poverty of speech, lack of motivation, flat affect) symptoms. Schizophrenia occurs throughout the world. The prevalence of schizophrenia (ie, the number of cases in a population at any one time point) approaches 1 percent internationally. The incidence (the number of new cases annually) is about 1.5 per 10,000 people. Slightly more men are diagnosed with schizophrenia than women (on the order of 1.4:1), and women tend to be diagnosed later in life than men. There is also some indication that the prognosis is worse in men. About 30 to 50% of people with schizophrenia fail to accept that they have an illness or their recommended treatment. While schizophrenia is noted for its psychotic symptoms and deficit features, cognitive impairments are important aspects of the illness as well. While these cognitive impairments are well known as predictors of different aspects of real-world functional outcomes, social disability in schizophrenia may have a number of additional determinants. One of the domains where in impairments may contribute to social disability in schizophrenia is social cognition. This is an area that is receiving an increase in attention that parallels the increased interest in cognition in schizophrenia over the past 10 years. Social cognition is defined as the ability to make inferences based on emotional information (emotion, perception or recognition), the ability to correctly identify and respond to social interactions and social rules or knowledge (social perception), and the ability to make inferences about another person's thoughts, feelings, and intentions. Impairment in each of these domains has been shown to have a significant impact on functional outcome in clients diagnosed with schizophrenia and explains variance in functional outcome beyond that accounted for by elementary neurocognition. Social cognition can be understood through a conceptual model which involves four specific domains: theory of mind (ToM), attribution style (AS), emotion recognition (ER) and social perception (SP).