Males and females with first episode psychosis present distinct profiles of social cognition and metacognition

Eur Arch Psychiatry Clin Neurosci. 2022 Oct;272(7):1169-1181. doi: 10.1007/s00406-022-01438-0. Epub 2022 Jul 8.

Abstract

Deficits in social cognition and metacognition impact the course of psychosis. Sex differences in social cognition and metacognition could explain heterogeneity in psychosis. 174 (58 females) patients with first-episode psychosis completed a clinical, neuropsychological, social cognitive, and metacognitive assessment. Subsequent latent profile analysis split by sex yielded two clusters common to both sexes (a Homogeneous group, 53% and 79.3%, and an Indecisive group, 18.3% and 8.6% of males and females, respectively), a specific male profile characterized by presenting jumping to conclusions (28.7%) and a specific female profile characterized by cognitive biases (12.1%). Males and females in the homogeneous profile seem to have a more benign course of illness. Males with jumping to conclusions had more clinical symptoms and more neuropsychological deficits. Females with cognitive biases were younger and had lower self-esteem. These results suggest that males and females may benefit from specific targeted treatment and highlights the need to consider sex when planning interventions.

Keywords: Metacognition; Profiles; Psychosis; Schizophrenia; Sex differences; Social cognition.

MeSH terms

  • Cognition
  • Cognition Disorders* / psychology
  • Female
  • Humans
  • Male
  • Metacognition*
  • Psychotic Disorders* / therapy
  • Social Cognition