Abstract
Schizophrenia patients are characterized by severe social impairments. Recently, social cognition has been put forward as an important mediator in schizophrenia between the often-reported neurocognitive deficits and functional outcome and is thus an important target for treatments. Nicotine has been reported to improve neurocognitive processes in schizophrenia patients but no studies have investigated possible nicotine-induced facilitation of social cognition. The current placebo-controlled crossover study aimed at bridging this gap by investigating whether the administration of active (1 mg or 2 mg) or placebo oromucosal nicotine spray resulted in improved social decision-making in non-smoking (N = 15) and smoking (N = 16) schizophrenia patients. All patients played the role of responder in a variant of the ultimatum game that allowed detailed measurements of fairness and intentionality considerations. The results showed impaired social decision-making in the non-smoking patients under placebo, but not in the smoking patients. Interestingly, this impairment normalized after administration of 1 mg of nicotine, but not after 2 mg of nicotine. Nicotine had no effect on performance in the smoking patients. The present study indicates that nicotine improves social decision-making in non-smoking patients. The present results suggest that acute nicotine effects may result in a facilitation of proactive control through improved attentional processes. However, the efficacy seems limited and although nicotine may thus be an interesting target for (social) cognitive enhancement in the subset of patients that do not smoke, more research is needed on the long-lasting effects of nicotine-based treatments.
Highlights
Schizophrenia is a debilitating disorder, accompanied by severe impairments ranging from delusions and hallucinations to disorganized thinking, mood disturbances, and cognitive dysfunctions (Burton, 2006)
One of the candidate components for cognitive enhancement is nicotine as both smoking and nicotine administration have been reported to improve sensory and attentional processes in humans
The aim of the current study was to investigate the effects of nicotine on social decision-making in smoking and nonsmoking schizophrenia patients
Summary
Schizophrenia is a debilitating disorder, accompanied by severe impairments ranging from delusions and hallucinations to disorganized thinking, mood disturbances, and cognitive dysfunctions (Burton, 2006). In line with the evident problems in social behavior, more recent studies have demonstrated that patients with schizophrenia are impaired in a wide range of social cognitive abilities, including emotion recognition (e.g., Kohler et al, 2010), mentalizing (e.g., Sprong et al, 2007; Harvey et al, 2013), and social decision-making (Csukly et al, 2011; Wischniewski and Brune, 2011) Cognitive dysfunctions, such as poor working memory performance, are known to be good predictors of functional outcome (Green et al, 2004). A growing number of studies have demonstrated nicotine to enhance neurocognitive processes in schizophrenia, such as sustained attention, anti-saccade performance, or delayed recognition (see e.g., Depatie et al, 2002; Myers et al, 2004; Barr et al, 2008) To this date, no one has investigated the effects of nicotine on social cognitive functioning in schizophrenia
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