Social Functioning In Schizophrenia Research Articles

Network Structures of Social Functioning Domains in Schizophrenia and Bipolar Disorder: A Preliminary Study.

ObjectiveThis study used network analyses to examine network structures reflecting interactions between specific domains of social functioning in schizophrenia (SZ) and bipolar disorder (BD).MethodsWe used the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) to assess six domains of social functioning (‘cognition’, ‘mobility’, ‘self-care’, ‘getting along’, ‘life activities’, and ‘participation’) in 143 patients with SZ, 81 patients with BD, and 106 healthy subjects. We constructed regularized partial correlation networks, estimated network centrality and edge strength, tested network stability, and compared SZ and BD network structures.ResultsPatients with SZ showed a significantly higher level of functional disability than patients with BD. In the networks we constructed, ‘cognition’ was the most central domain of social functioning in both SZ and BD. The ‘cognition’ domain was primarily associated with the ‘getting along’ domain in the SZ network and the ‘life activities’ domain in the BD network. We found no significant group-level differences in network structures for SZ vs. BD.ConclusionOur results suggest that cognition may play a pivotal role in social functioning in both SZ and BD. In addition, domains of social functioning in SZ and BD have similar network structures despite the higher level of disability in SZ compared to BD.

Dynamic causal modeling of eye gaze processing in schizophrenia

BackgroundAbnormal eye gaze perception is related to symptoms and social functioning in schizophrenia. However, little is known about the brain network mechanisms underlying these abnormalities. Here, we employed dynamic causal modeling (DCM) of fMRI data to discover aberrant effective connectivity within networks associated with eye gaze processing in schizophrenia. MethodsTwenty-seven patients (schizophrenia/schizoaffective disorder, SZ) and 22 healthy controls (HC) completed an eye gaze processing task during fMRI. Participants viewed faces with different gaze angles and performed explicit gaze discrimination (Gaze: “Looking at you?” yes/no) or implicit gaze processing (Gender: “male or female?”). Four brain regions, the secondary visual cortex (Vis), posterior superior temporal sulcus (pSTS), inferior parietal lobule (IPL), and posterior medial frontal cortex (pMFC) were identified as nodes for subsequent DCM analysis. ResultsSZ and HC showed similar generative model structure, but SZ showed altered connectivity for specific self-connections, inter-regional connections during all gaze processing (reduced excitatory bottom-up and enhanced inhibitory top-down connections), and modulation by explicit gaze discrimination (increased frontal inhibition of visual cortex). Altered effective connectivity was significantly associated with poorer social cognition and functioning. ConclusionsGeneral gaze processing in SZ is associated with distributed cortical dysfunctions and bidirectional connectivity between regions, while explicit gaze discrimination involves predominantly top-down abnormalities in the visual system. These results suggest plausible neural mechanisms underpinning gaze processing deficits and may serve as bio-markers for intervention.

Effect of disease related biases on the subjective assessment of social functioning in Alzheimer's disease and schizophrenia patients

BackgroundQuestionnaires are the current hallmark for quantifying social functioning in human clinical research. In this study, we compared self- and proxy-rated (caregiver and researcher) assessments of social functioning in Schizophrenia (SZ) and Alzheimer's disease (AD) patients and evaluated if the discrepancy between the two assessments is mediated by disease-related factors such as symptom severity. MethodsWe selected five items from the WHO Disability Assessment Schedule 2.0 (WHODAS) to assess social functioning in 53 AD and 61 SZ patients. Caregiver- and researcher-rated assessments of social functioning were used to calculate the discrepancies between self-rated and proxy-rated assessments. Furthermore, we used the number of communication events via smartphones to compare the questionnaire outcomes with an objective measure of social behaviour. ResultsWHODAS results revealed that both AD (p < 0.001) and SZ (p < 0.004) patients significantly overestimate their social functioning relative to the assessment of their caregivers and/or researchers. This overestimation is mediated by the severity of cognitive impairments (MMSE; p = 0.019) in AD, and negative symptoms (PANSS; p = 0.028) in SZ. Subsequently, we showed that the proxy scores correlated more strongly with the smartphone communication events of the patient when compared to the patient-rated questionnaire scores (self; p = 0.076, caregiver; p < 0.001, researcher-rated; p = 0.046). ConclusionHere we show that the observed overestimation of WHODAS social functioning scores in AD and SZ patients is partly driven by disease-related biases such as cognitive impairments and negative symptoms, respectively. Therefore, we postulate the development and implementation of objective measures of social functioning that may be less susceptible to such biases.

Oxytocin Pathway Polymorphisms and Social Functioning in Schizophrenia

Poster presented at Forum for Interdisciplinary Research in Medicine, Science &amp; Technology Conference, Moscow 4-5 Aug 2020&#x0D; Peer reviewed by JS Bamrah, Ananthakrishnan Raghuraman, Soumit Dasgupta &amp; Jyothi Srinivasan

Attributional Styles and Social Functioning in Schizophrenia. Is the Learned Helplessness Model Suitable?

We tried to verify whether the reformulated Learned Helplessness Model and its more fully articulated form, the Hopelessness Theory of Depression, were adequate to predict symptoms and social functioning (SF) in persons with schizophrenia-spectrum disorders by comparing a clinical group (n = 25) with a non-clinical one (n = 30). Bivariate correlations and multiple linear regressions were conducted to assess relationships between the Attribution Styles Questionnaire (ASQ), clinical variables, and SF within the clinical group. Differences between groups were found for most of attributional dimensions. A “pessimistic style” predicted depression within the clinical group. An unstable attribution bias predicted positive symptoms. General psychopathology and a global attribution style predicted 50% of the variance in general SF. The Learned Helplessness Model was suitable to predict depression regardless of psychotic symptoms and may be useful to predict clinical symptoms and SF in persons with schizophrenia spectrum disorders. Clinical and theoretical implications were discussed.

Clinical symptoms and social functioning in schizophrenia.

The aim of the present study was to assess the relationship between social functioning and clinical symptoms in people with schizophrenia, analyzing the influence of both global social functioning and the specific aspects of social functioning, assertiveness and communication skills in the explanation of type of symptoms. A cross-sectional descriptive study composed of 125 people diagnosed with schizophrenia was performed. Patients were assessed with the Communication Skills Questionnaire (CSQ), the Gambrill and Richey Assertiveness Inventory (GR), the Global Assessment of Functioning Scale (GAF) and the Global Assessment of Social Functioning Scale (SOFAS), Social Functioning Scale (SFS), Life Skills Profile (LSP) scale and the Clinical Global Impression scale for Schizophrenia (CGI-S). SOFAS, LSP and GR are related to each of the subscales and total scores of symptoms (p<0.05-0.001). The multiple regressions show that SOFAS and GR explained 59% of the total symptoms. SOFAS and GR, accounting for 65% of the variance, explain positive symptoms. GR and SOFAS explained 34% of the variance of negative symptoms. SOFAS, CSQ and LSP, accounting for 20% of the variance, explain depressive symptoms. SOFAS explained 46% of the variance of cognitive symptoms. Our findings suggest the usefulness of social functioning assessment in the explanation of clinical symptoms in people with schizophrenia. Moreover, our results point out that not only negative and cognitive symptoms, but also positive and depressive symptoms, should be taken into account in the rehabilitation process in order to improve patient adaptation in the community.

Anxiety Mediates the Relationship between Psychotic-Like Experiences and Social Functioning in the General Population

Introduction: Within the psychosis continuum that includes schizophrenia (SZ) at the severe end and the general population at the mild end, anxiety may negatively impact social functioning more than psychosis or psychotic-like experiences (PLE). This claim is supported by previous reports that show anxiety mediates the relationship between psychosis and social functioning in SZ, suggesting anxiety is critical to social functioning in SZ. Yet no studies have examined a similar relationship in the general population, and this is important because people with PLE are at a significantly higher risk for developing full-blown psychosis. Methods: Similar to those with SZ, we predicted heightened anxiety would mediate the relationship between PLE, as measured by The ­Oxford-Liverpool Inventory of Feelings and Experiences, and social functioning, as measured by Social Adjustment Scale – Self-Report, in the general population. Results: Indeed, the current study showed that the relationship between PLE and social functioning was mediated by anxiety (z = 7.81, p < 0.001) within an unselected crowdsourcing sample representative of the general population (Amazon M-Turk; n = 197, mean age 32.38 years). Conclusion: Taken together with previous reports, the current findings suggest that anxiety is a functionally relevant dimension across the psychosis continuum and improving anxiety may improve social functioning across this continuum.

Online Social Cognition Training in Schizophrenia: A Double-Blind, Randomized, Controlled Multi-Site Clinical Trial.

Social cognition (SC), the mental operations underlying social functioning, are impaired in schizophrenia. Their direct link to functional outcome and illness status have made them an important therapeutic target. However, no effective treatment for these deficits is currently applied as a standard of care. To address this need, we have developed SocialVille-an online, plasticity-based training program that targets SC deficits in schizophrenia. Here we report the outcomes of a double-blind, controlled, randomized, multi-site clinical trial of SocialVille. Outpatients with schizophrenia were randomized to complete 40 sessions of either SocialVille (N = 55 completers) or active control (computer games; N = 53 completers) from home. The a priori co-primary outcome measures were a social cognitive composite and a functional capacity outcome (UCSD Performance-based Skills Assessment [UPSA-2]). Secondary outcomes included a virtual functional capacity measure (VRFCAT), social functioning, quality of life, and motivation. Linear mixed models revealed a group × time interaction favoring the treatment group for the social cognitive composite (b = 2.81; P < .001) but not for the UPSA-2 measure. Analysis of secondary outcome measures showed significant group × time effects favoring the treatment group on SC and social functioning, on the virtual functional capacity measure and a motivation subscale, although these latter findings were nonsignificant with FDR correction. These results provide support for the efficacy of a remote, plasticity-based social cognitive training program in improving SC and social functioning in schizophrenia. Such treatments may serve as a cost-effective adjunct to existing psychosocial treatments. Trial Registration: NCT02246426.

Autistic Symptoms and Social Cognition Predict Real-World Outcomes in Patients With Schizophrenia.

ObjectiveReal-world functioning is a complex construct influenced by different factors. The impact of social cognition and autism spectrum disorder (ASD) symptoms on different aspects of the life of people with schizophrenia has been demonstrated independently, but it is unclear how these factors are related to functioning when considered concurrently. We hypothesized that ASD symptoms could play a major role in predicting real-world functioning in schizophrenia.MethodsExistent databases from two studies (SCOPE Phase 3 and SCOPE Phase 5), in which a total of 361 patients (mean age 41.7 years; 117 females) were assessed with measures of symptom severity, neuro- and socio-cognitive abilities, functional capacity, social skills, and informant-reported real-world functioning outcomes, were analyzed.ResultsActive social avoidance, social skills, ASD symptoms, and emotion processing emerged as predictors of real-world interpersonal relationships. Cognitive performance, positive symptoms, and functional capacity emerged as predictors of real-world participation in daily activities. Cognitive performance, emotion processing, positive symptoms severity, and social skills emerged as predictors of real-world work outcomes.ConclusionAmong other demographic, clinical, and functional capacity variables, increased ASD symptoms emerged as a significant predictor of poorer social relationships and may therefore represent a key factor in predicting real-world social functioning in schizophrenia.

T227. VIRTUAL REALITY SOCIAL SKILLS TRAINING IMPROVES SOCIAL ATTENTION IN INDIVIDUALS WITH SCHIZOPHRENIA

BackgroundSocial impairment is a core feature of schizophrenia presenting a major barrier to recovery. Although antipsychotic medications can reduce psychotic symptoms, social impairments often persist, contributing to poor outcome. Validated interventions, such as Social Skills Training (Bellack et al., 2004), target a broad range of social domains but they yield only modest effect sizes for social outcome (Pfammatter et al, 2006). Moreover, conventional social interventions suffer from high burden on the clients and therapists, low adherence, lack of personalization, and low generalizability. Importantly, social interventions are not widely available. Virtual reality (VR) offers a viable alternative to conventional therapies with several advantages including high acceptability, an extensive repertoire of stimuli, low-burden, low-cost and safety (Strickland, 1997). Importantly, VR allows for a precise targeting of social cognitive mechanisms. Social attention, the fast orientation and allocation of resources to social stimuli can be indexed by tracking eye movements. Abnormal eye scanning behavior during social interactions has been linked to poor social functioning in schizophrenia (Brunet-Gouet & Decety, 2006). We designed a VR-based social skills training game to directly target social attention in schizophrenia.MethodsEighteen individuals with schizophrenia (SZ) participated in the VR training game twice a week for 5 weeks. Eye movement patterns were recorded throughout the training. Subjects were required to solve social “missions” (e.g., obtain personal information through conversations with avatars) in different naturalistic scenarios. To start a mission, participants had to fixate on the chosen avatar. The latency to engage in a social interaction was indexed by the fixation time (social engagement latency). Each session consisted of 12 missions. We compared social engagement latency and eye gaze patterns pre- and post-training to assess the efficacy of the VR social skills training program.ResultsSocial engagement latency significantly decreased after 10 sessions (d=0.78). This result suggests that prosocial attention benefitted from VR training. We also found that the standard deviation of dwell time (i.e., proportion of time spent looking at the avatar’s face during a conversation) significantly increased across training sessions (d=0.56). This result suggests an increased modulation of interpersonal engagement during social interaction. Additionally, participants’ emotion recognition ability significantly increased (η2 = 0.27), and negative symptoms significantly decreased (η2=0.34) from pre- to post- training. Importantly, these changes in social attention correlated with improvement in negative symptoms.DiscussionSimulated and targeted social interactions with avatars in VR significantly improved social attention in individuals with schizophrenia. Importantly, improvements in negative symptoms and emotion perception after training suggest that this training protocol has an impact on a broad range of social functions. VR training is a promising alternative to traditional psychosocial interventions to target specific mechanisms underlying social functioning in schizophrenia.

M135. DEVELOPMENT OF VISUAL SCANPATH PATTERN ANALYSIS BASED ON FACIAL EMOTION PERCEPTION ENHANCEMENT TRAINING PROGRAM IN SCHIZOPHRENIA PATIENTS

BackgroundFacial expression is an important non-verbal way of expressing the person’s emotional state. If the process of perceiving facial features is impaired, the ability to recognize the emotional state of others is degraded, which may make it difficult to maintain interpersonal and social communications. Many studies have reported on the association between deficit of facial emotion perception (FEP) and the social functioning in schizophrenia. Therefore, we developed visual scanpath pattern analysis based FEP enhancement training program in schizophrenia.MethodsWe enrolled patients visited and admitted Gongju National Hospital and those lived in shared housing facilities for rehabilitation from Sep 2018 to May 2019. 128 patients attended to FEP training program as open, blind and randomized-controlled cross-over design. Both FEP training and mock programs were provided twice a week for a month treatment period with a 4-week washout period between treatment periods. Primary outcome was results of heatmaps based on visual scanpath patterns.ResultsAmong 128 patients, 121 completed the study and 7 was dropped out. In FEP training group, their visual scanpath pattern somewhat closer to normal than mock group. When they had an efforts to perceive the emotion of face pictures, FEP training group tended to scan the face pictures more broadly including eye rims, middle of forehead and sided of the mouth in addition to eyes, nose and mouth whereas mock group tended to gaze eyes, nose and mouth intensively.DiscussionThis FEP training program may improve the ability to integrate facial expression cues through visual scanpath pattern changes in schizophrenia patients.Acknowledgement: This work was supported by the National Research Foundation of Korea (NRF) (Grant number NRF-2016R1E1A2A01953732 & 2018R1E1A2A02059043).

The link between formal thought disorder and social functioning in schizophrenia: A meta-analysis.

Formal thought disorder (FTD) and social functioning impairments are core symptoms of schizophrenia. Although both have been observed for over a century, the strength of the relationship between FTD and social functioning remains unclear. Furthermore, a variety of methodological approaches have been used to assess these constructs-which may contribute to inconsistency in reported associations. This meta-analysis aimed to: (a) systematically test the relationship between FTD and social functioning and (b) determine if the methodology used to assess FTD and/or social functioning moderates this relationship. Following Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines, a targeted literature search was conducted on studies examining the relationship between FTD and social functioning. Correlations were extracted and used to calculate weighted mean effect sizes using a random effects model. A total of 1,478 participants across 13 unique studies were included in this meta-analysis. A small-medium inverse association (r= -0.23, p<0.001) was observed between FTD and social functioning. Although heterogeneity analyses produced a significant Q-statistic (Q= 52.77, p= <0.001), the relationship between FTD and social functioning was not moderated by methodology, study quality, demographic variables, or clinical factors. Findings illustrate a negative association between FTD and social functioning. Despite differences in the methodological approach used and type of information assessed, measurement type and clinical factors did not moderate the relationship between FTD and social functioning. Future studies should explore whether other variables, such as cognitive processes (e.g., social cognition), may account for variability in associations between these constructs.

Metacognitive Capacity Is Related to Self-Reported Social Functioning and May Moderate the Effects of Symptoms on Interpersonal Behavior.

Impairments in metacognition or the ability to form integrated senses of self and others have been linked to deficits in laboratory-based measures of social functioning in schizophrenia. This study examined whether self-reported social functioning was related to metacognition in 88 adults in a nonacute phase of schizophrenia. Concurrent assessments were made of metacognition with the Metacognition Assessment Scale-Abbreviated, social functioning with the Social Functioning Scale, symptoms with the Positive and Negative Syndrome Scale, and neurocognition with the Wisconsin Card Sorting Task. Univariate correlations revealed that self-reported social functioning was related to metacognition. Symptom severity was linked to interpersonal relationships, and overall metacognition was found to significantly moderate that relationship such that the effects of symptoms on function grew less as metacognitive capacity was stronger, independent of the effects of neurocognition. This may suggest the potential of metacognitive interventions to titrate the negative effects of symptoms on social function.

Impact of Positive Emotion Regulation Training on Negative Symptoms and Social Functioning in Schizophrenia: A Field Test.

Background: The poor efficacy of drug or psychological treatments on the primary negative symptoms of schizophrenia has led to the development of new interventions. The Positive Emotions Program for Schizophrenia (PEPS) is an emotion regulation strategy training that aims to intensify positive emotions and develop positive performance beliefs. A randomized controlled trial showed that PEPS is effective in reducing the composite score of the reduction of experience syndrome (anhedonia and apathy). The present study is designed to evaluate its feasibility in natural conditions to measure external validity of PEPS. Materials and Methods: Twenty-one participants recruited through the French national network of expert centers followed eight sessions of PEPS and were assessed pre- and posttest with the Scale for Assessment of Negative Symptoms (SANS) and the Personal and Social Performance (PSP). The scales of the SANS were divided into a composite score of the reduction of the ability to experience and a composite score of the reduction of expression. Results: All participants followed the 8 sessions of PEPS, and both composite scores were significantly and clinically improved at posttest. Social functioning assessed with the PSP was also improved. Conclusions: This field test shows that participation in PEPS is accompanied by a reduction of negative symptoms and an improvement of social functioning. Both negative syndromes, reduction of expression and reduction of experience, are improved. Participants are younger than those in previous studies, which may explain this unexpected result. However, this calls for a controlled study with younger participants.

Empathy for others' pain is disrupted at the neurophysiological level in schizophrenia.

Previous research has shown that empathy for pain is disrupted at the neural level in people with schizophrenia. However, many of these studies have failed to assess key background contextual variables that have previously been linked to neurophysiological responding. Moreover, no study to date has examined the potential influence of schizotypal characteristics on neurophysiological responding in non-clinical individuals. People with schizophrenia (N=17) were compared to demographically matched controls (N=19) on an event-related potential (ERP) empathy for painparadigm. The control group also completed a measure of schizotypal personality traits. People with schizophrenia exhibited atypical neural responding at early, emotion-sharing (frontal N110), and late, cognitive (central late positive potential [LPP]) processing stages of pain empathy, relative to controls. In the control group, positive schizotypy traits were significantly negatively related to reduced ERP amplitude in the late, cognitive (central LPP) processing stage of empathy. These data cross-validate previous studies that have shown that schizophrenia is associated with atypicalities in bottom-up automatic resonance processes that likely contribute to empathic and socio-emotional processing deficits, and indicate that these findings cannot be easily attributed to background contextual differences between the two groups. The results also point to a potential relationship between positive schizotypal characteristics and neurophysiological responding. Implications for simulation theories of empathy and social functioning in schizophrenia are discussed. Empathic processing has been consistently linked to well-being and mental health in many groups, including people with schizophrenia. Previous research has shown that, relative to controls, people with schizophrenia exhibit abnormalities in their neurophysiological empathic response, but in these prior studies, the two groups also differed in a number of potentially important background contextual variables. The current study shows that, when closely matched on background contextual variables, abnormal neural responding is still evident. These data suggest that empathy for pain is disrupted at the neurophysiological level in schizophrenia.

Association between the Thalamus and Social Function in Schizophrenia

Patients with schizophrenia face several difficulties in their daily social life owing to the impairment of social cognitive ability. However, the neural basis of this impairment has not been fully clarified. We attempted to identify the neuronal basis of social dysfunction of schizophrenia by focusing on the thalamus, which is a subcortical structure. We have shown that right thalamic volume, as well as white matter integrity between the right thalamus and right frontal lobe, is associated with the social function of patients with schizophrenia, by using T1-weighted magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) data. These findings suggested that neural network abnormalities between the thalamus and the frontal lobe can be related to social dysfunction in patients with schizophrenia. Thus, these findings may contribute to the development of new treatments for schizophrenia.

Social cognition in early course of schizophrenia: Exploratory factor analysis

Social cognition is a central contributor to social functioning in schizophrenia. A better understanding of the underlying structure of social cognition in the early course schizophrenia could help us identify more precise targets for intervention in this population. In the present study, we performed an Exploratory Factor Analysis (EFA) on 90 patients within the early course of schizophrenia using 11 validated subtests assessing various domains of social cognitive skills. The factors derived from this analysis were then used to investigate relationships between these distinct domains of social cognition skills and neurocognitive performance, clinical symptoms, and social functioning satisfaction. The results revealed the presence of a 3-factor solution, representing the domains of Emotion Management, Emotion Recognition, and Theory of Mind, together accounting for 55.88% of the variance. Moreover, higher scores on the Theory of Mind factor were significantly related to higher social functioning satisfaction measures as well as with lower clinical symptoms severity. Our findings suggest that social cognitive skills are composed of three separate domains in the early course of schizophrenia and that theory of mind could be an important therapeutic target for early intervention.

Implicit and explicit bodily emotions and social functioning in schizophrenia

Previous research has identified altered processing of emotional information associated with the bipolar spectrum, but results have been inconsistent. The current study assessed whether hypomanic personality traits, a potential indicator of bipolar risk, are associated with biases in attention to emotional facial stimuli, even after controlling for mood state.Participants (N = 135) completed measures assessing current mood symptoms, positive and negative affect, and hypomanic personality traits. They then completed an eye-tracking task measuring two indices of attention (i.e., mean initial orientation latency, mean total gaze duration) for happy, sad, angry, and neutral facial expressions.Even after controlling for mood state, hypomanic personality traits were associated with a bias for emotion faces as well as a trend towards faster orientation to happy facial expressions.Due to relatively low levels of mania in this sample, further work is needed to assess the extent to which these effects exist at clinical levels of depression or mania. Additionally, further work is needed to determine if such a bias represents a risk factor for the development of bipolar disorder.Hypomanic personality traits appear to be associated with differences in early attention for emotional information.

Metacognitive deficits and social functioning in schizophrenia across symptom profiles: A latent class analysis

Functional deficits are a hallmark of schizophrenia spectrum disorders, but much debate still exists over why and how they originate. One model suggests that disturbances in social functioning are a result of metacognitive deficits or a failure to integrate information to form more complex ideas of themselves and others. It is unclear if this social dysfunction is present across different symptom presentations. We examined the relationship of metacognition, symptoms, and social functioning among a sample of adults with schizophrenia spectrum disorders ( N = 334). A latent class analysis produced a four-class model. Groups were classified as follows: diffuse symptoms/moderately impaired social functioning (Class 1), positive and hostility symptoms/mildly impaired social functioning (Class 2), minimal symptoms/good social functioning (Class 3), and negative and cognitive symptoms/severely impaired social functioning (Class 4). Class 3 demonstrated better overall metacognitive capacity than both Classes 1 and 4 but did not differ significantly from Class 2. Classes 2 and 3 both demonstrated better interpersonal functioning than Classes 1 and 4. Together, these findings provide support for models of poor functioning that stem from fragmentation of an individual’s experience, leading to diminished abilities to form meaningful connections with others. Additional interpretations, limitations, and research implications are discussed.

Patterns of obsessive-compulsive symptoms and social functioning in schizophrenia; a replication study

Research has found that Obsessive Compulsive Symptoms (OCS) in schizophrenia are associated with either more or less negative symptoms and either better or poorer cognitive functioning. In order to explain these contradictory results, (Lysaker et al., 2004), performed a cluster analysis resulting in 2 OCS positive (OCSpos) clusters, one with higher functioning (HF) and one with poorer functioning (PF) compared to 2 OCS negative (OCSneg) clusters. The OCSpos/HF cluster had less negative symptoms compared to all other clusters, while the OCSpos/PF cluster showed poorer executive functioning. We performed a replication study, in an almost 10 times larger, representative sample, using both a longitudinal and cross-sectional design. Similar to Lysaker et al., we found a group with mild OCS and HF (OCSmild/HF) showing less negative symptoms compared to the PF groups. We also found an OCSmild/PF group, which did not significantly differ in executive functioning from the other groups. Moreover, we did not find evidence for a better prognosis in the OCSmild/HF group, and thus found no support for the assumption that for some patients OCS might be an effective coping mechanism.