Abstract
IntroductionIn patients with psychotic disorders, both tobacco smoking and deficits in social cognition and social functioning are highly prevalent. However, little is known about their relationship in psychosis. The authors sought to evaluate the multi-cross-sectional and longitudinal associations between tobacco smoking, social cognition and social functioning in a large prospective study. MethodsThis study was performed within the Genetic Risk and Outcome of Psychosis (GROUP) Study, a cohort study conducted in patients with non-affective psychosis (N = 1074), their unaffected siblings (N = 1047) and healthy controls (N = 549). At baseline, three years and six years of follow-up, data on tobacco smoking (using the Composite International Diagnostic Review), social cognition (emotion processing and theory of mind) and social functioning were collected. To assess associations between tobacco smoking and social cognition or social functioning, multivariate linear mixed-effects models and multiple linear regression models were used. Bonferroni correction for multiple testing was applied. ResultsA significant positive association was found between smoking and emotion processing (as part of social cognition) in the patient group (estimate = 1.96, SE = 0.6, p = 0.003). However, smoking was significantly negatively associated with participating in pro-social activities compared with non-smoking (estimate = −2.55, SE = 0.9, p = 0.004). Change in smoking behaviour was not associated with social cognition or social functioning in the longitudinal analyses. ConclusionFindings indicate that smoking patients with a non-affective psychotic disorder slightly outperformed their non-smoking peers on a task on social cognition, but participated less in pro-social activities. Commencement or cessation of smoking was not related to social cognition or functioning.
Highlights
In patients with psychotic disorders, both tobacco smoking and deficits in social cognition and social functioning are highly prevalent
Data on smoking status were available for 1.074 patients, 1.047 siblings and 549 healthy controls
We explored the associations of tobacco smoking, social cognition and social functioning in a sample of patients with a non-affective psy chotic disorder, unaffected siblings and healthy controls over a period of six years
Summary
In patients with psychotic disorders, both tobacco smoking and deficits in social cognition and social functioning are highly prevalent. Conclusion: Findings indicate that smoking patients with a non-affective psychotic disorder slightly outperformed their non-smoking peers on a task on social cognition, but participated less in pro-social activities. A prominent feature of individuals with psychosis is reduced cognitive performance including social cognition (Savla et al, 2013). The latter is introduced as one of seven impaired cognitive domains in the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) (Nuechterlein et al, 2004). Facial affect recognition (which is often impaired in psychosis (Kohler et al, 2010)) is an important aspect of social functioning (Hofer et al, 2009)
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