Neurocognition and social cognition in patients with schizophrenia spectrum disorders with and without a history of violence: results of a multinational European study

Giovanni De Girolamo,Johannes Wancata,Marlene Koch,Clarissa Ferrari,Laura Iozzino,Pawel Gosek,Nicola Canessa,Philip D Harvey,Marco Picchioni,Ambra Macis,Hans Joachim Salize,Janusz Heitzman

doi:10.1038/s41398-021-01749-1

Abstract

ObjectiveNeurocognitive impairment has been extensively studied in people with schizophrenia spectrum disorders and seems to be one of the major determinants of functional outcome in this clinical population. Data exploring the link between neuropsychological deficits and the risk of violence in schizophrenia has been more inconsistent. In this study, we analyse the differential predictive potential of neurocognition and social cognition to discriminate patients with schizophrenia spectrum disorders with and without a history of severe violence.MethodsOverall, 398 (221 cases and 177 controls) patients were recruited in forensic and general psychiatric settings across five European countries and assessed using a standardized battery.ResultsEducation and processing speed were the strongest discriminators between forensic and non-forensic patients, followed by emotion recognition. In particular, increased accuracy for anger recognition was the most distinctive feature of the forensic group.ConclusionsThese results may have important clinical implications, suggesting potential enhancements of the assessment and treatment of patients with schizophrenia spectrum disorders with a history of violence, who may benefit from consideration of socio-cognitive skills commonly neglected in ordinary clinical practice.

Highlights

It is a general impression that people with schizophrenia spectrum disorders (SSD) can be violent or dangerous
Translational Psychiatry (2021)11:620 we focused on the misidentification of anger from other emotions to check were lower than the other countries, while controls’ refusal rate for the presence of a hostile misattribution bias on emotion recognition task (ER) performance
In a recent cohort study involving patients with severe mental disorders (N = 247 patients with SSD), where approximately half had a history of violence and the other half was never violent, we found that patients with an history of violence and who committed new acts of violence during the 1-year follow-up showed poorer performance on the Symbol Coding Task compared to non-violent patients [50]

Summary

OBJECTIVE

Neurocognitive impairment has been extensively studied in people with schizophrenia spectrum disorders and seems to be one of the major determinants of functional outcome in this clinical population. Aims of the study In the present study, we examine the differential predictive paper-and-pencil standardized neuropsychological instrument used to evaluate cognitive impairments and their relationship with functional outcomes in patients with schizophrenia It includes six tests measuring potential of neurocognition and SC to discriminate violent forensic different cognitive constructs: verbal (list learning) and working Univariate and multiple logistic models were performed to investigate the association sample of 57 healthy adults (32 females) recruited from acquaintances of researchers Both patient groups displayed worse emotion recognition skills compared with healthy individuals; only non-forensic patients had significant lower scores than healthy subjects after adjusting for gender and education.

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