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

• Published in: Neuroscience and biobehavioral reviews Vol. 105; pp. 212 - 219
• Main Authors: Halverson, Tate F., Orleans-Pobee, Maku, Merritt, Carrington, Sheeran, Paschal, Fett, Anne-Kathrin, Penn, David L.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.10.2019
• Subjects: Community functioning; Functional outcome; Neurocognition; Psychosis; Quality of life; Schizophrenia; Social cognition; Psychosis; Schizophrenia; Community functioning; Neurocognition; Functional outcome; Quality of life; Social cognition
• ISSN: 0149-7634; 1873-7528; 1873-7528
• DOI: 10.1016/j.neubiorev.2019.07.020

•Meta-analysis of 166 studies (12,868 individuals with schizophrenia)•Neurocognition and social cognition show small to medium effects with functioning.•Social cognition domains explained more unique variance in functional outcomes.•Social cognition is a partial mediator between neurocognition and functioning. 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.