Background:In schizophrenia, social cognition is strongly linked to functional outcome and is increasingly seen as a viable treatment target. The goal of the Social Cognition Psychometric Evaluation (SCOPE) study is to identify and improve the best existing measures of social cognition so they can be suitably applied in large-scale treatment studies. Initial phases of this project sought to (1) develop consensus on critical domains of social cognition and (2) identify the best existing measures of social cognition for use in treatment studies. Methods: Experts in social cognition were invited to nominate key domains of social cognition and the best measures of those domains. Nominations for measures were reduced according to set criteria, and all available psychometric information about these measures was summarized and provided to RAND panelists. Panelists rated the quality of each measure on multiple criteria, and diverging ratings were discussed at the in-person meeting to obtain consensus. Results: Expert surveys identified 4 core domains of social cognitionemotion processing, social perception, theory of mind/mental state attribution, and attributional style/bias. Using RAND panel consensus ratings, the following measures

The COVID-19 pandemic has presented a formidable challenge to care continuity for community mental health clients with serious mental illness and for providers who have had to quickly pivot the modes of delivering critical services. Despite these challenges, many of the changes implemented during the pandemic can and should be maintained. These include offering a spectrum of options for remote and in-person care, greater integration of behavioral and physical healthcare, prevention of viral exposure, increased collaborative decision-making related to long-acting injectable and clozapine use, modifying safety plans and psychiatric advance directives to include new technologies and broader support systems, leveraging natural supports, and integration of digital health interventions. This paper represents the authors' collaborative attempt to both reflect the changes to clinical practice we have observed in CMHCs across the US during this pandemic and to suggest how these changes can align with best practices identified in the empirical literature.

Researchers have repeatedly observed that clinicians diagnose Black individuals with schizophrenia at greater rates than White individuals. We conducted a meta-analytic review to quantify the extent of racial diagnostic disparities in schizophrenia, examine whether structured-interview assessments attenuate these disparities, and assess for moderating factors. Studies were included that presented original probability-sample data and reported data sufficient to derive odds ratios and 95% confidence intervals (CIs) for schizophrenia diagnosis by race. In total, 14 studies using structured-interview diagnostic assessments and 41 studies using unstructured assessments met our inclusion criteria. Substantial heterogeneity was observed, but there was little evidence of publication bias. Inverse heterogeneity models showed that Black individuals were diagnosed with schizophrenia at greater rates than White individuals across all studies (OR = 2.42, 95% CI [1.59, 3.66]) as well as in studies using unstructured (OR = 2.43, 95% CI [1.59, 3.72]) and structured-instrument (OR = 1.77, 95% CI [1.31, 2.38]) diagnostic assessments. Studies using structured-instrument diagnostic assessments did not show statistically attenuated odds ratios compared with studies using unstructured assessments. Metaregression analyses indicated higher disparities in studies with higher proportions of White patients or lower average patient age; evidence was equivocal as to the effect of study setting (e.g., hospital vs. community clinic) and geographic region on racial disparities. Overall, racial diagnostic disparity in schizophrenia represents a robust albeit heterogeneous clinical phenomenon that has been stable over the past 3 decades; structured-instrument assessments do not fully mitigate these disparities, but power analysis suggests they may have a small effect. (PsycINFO Database Record

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