Pathways to functional outcomes in schizophrenia spectrum disorders: Meta-analysis of social cognitive and neurocognitive predictors

Tate F Halverson; Maku Orleans-Pobee; Carrington Merritt; Paschal Sheeran; Anne-Kathrin Fett; David L Penn

doi:10.1016/j.neubiorev.2019.07.020

Pathways to functional outcomes in schizophrenia spectrum disorders: Meta-analysis of social cognitive and neurocognitive predictors

Neurosci Biobehav Rev. 2019 Oct:105:212-219. doi: 10.1016/j.neubiorev.2019.07.020. Epub 2019 Aug 12.

Authors

Tate F Halverson¹, Maku Orleans-Pobee¹, Carrington Merritt¹, Paschal Sheeran¹, Anne-Kathrin Fett², David L Penn³

Affiliations

¹ University of North Carolina at Chapel Hill, Department of Psychology and Neuroscience, Chapel Hill, NC 27599, USA.
² City University of London, Department of Psychology, London, UK; Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, and Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London SE5 8AF, UK.
³ University of North Carolina at Chapel Hill, Department of Psychology and Neuroscience, Chapel Hill, NC 27599, USA; Australian Catholic University, School of Behavioural and Health Sciences, Melbourne, VIC, Australia.

PMID: 31415864
DOI: 10.1016/j.neubiorev.2019.07.020

Abstract

The current meta-analysis explored relationships between functional outcomes in schizophrenia spectrum disorders and different domains of neurocognition and social cognition. Literature searches were conducted in PsycINFO, PubMed, and ProQuest to identify articles reporting correlations between cognition domains and functional outcomes. Of 1361 articles identified, 166 met all inclusion criteria (12,868 participants; 518 correlations). Fifty-three random-effects meta-analyses yielded mean correlation estimates for relationships between neurocognition and social cognition and functional outcomes. Overall, associations between social cognition and neurocognition, and functional outcomes demonstrated significant small-to-medium effect sizes. Social cognition explained more unique variance in functioning than neurocognition (7.3% vs. 4.4%; 9.2% total average variance). Social cognition also mediated the relationship between neurocognition and functional outcomes. A significant proportion of the variance in the relationships between cognition and functional outcomes remained unexplained. These findings suggest that integrated interventions targeting both neurocognition and social cognition may optimally improve functional outcomes. Standardized measurement of cognition and functioning, longitudinal studies, and tests of additional moderators (e.g., first episode samples) in future research were identified as important future directions.

Keywords: Community functioning; Functional outcome; Neurocognition; Psychosis; Quality of life; Schizophrenia; Social cognition.

Publication types

Meta-Analysis
Review

MeSH terms

Brain / physiopathology*
Humans
Psychotic Disorders / physiopathology*
Schizophrenia / physiopathology*
Social Behavior*
Social Perception*