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

Deste, Giacomo; Vita, Antonio; Nibbio, Gabriele; Penn, David L.; Pinkham, Amy E.; Harvey, Philip D.

doi:10.3389/fpsyt.2020.00524

Cited by 31 publications

(20 citation statements)

References 53 publications

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“…The recognition of emotions, assessed using the TREF, was positively associated with functioning beyond neurocognition and symptoms. This result is consistent with previous reports that showed associations between the recognition of emotions, as measured by the ER-40 and BLERT tasks, and functioning beyond neurocognition 8 , 11 , 25 .…”

Section: Discussionsupporting

confidence: 93%

Outcome prediction with a social cognitive battery: a multicenter longitudinal study

et al. 2021

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The interest in social cognition in schizophrenia is justified by the relationship between deficits in these skills and negative functional outcomes. Although assessment batteries have already been described, there is no consensus about which measures are useful in predicting patient functioning or quality of life (QoL). We investigated a set of five measures of recognition of facial emotions, theory of mind (ToM), and empathy in a cohort of 143 patients with schizophrenia or schizoaffective disorder at inclusion and, amongst whom 79 were reassessed 1 year later. The distribution was satisfactory for the TREF (Facial Emotion Recognition Task), V-SIR (Versailles-Situational Intention Reading), and QCAE (Questionnaire of Cognitive and Affective Empathy). Internal consistency was satisfactory for the TREF, V-SIR, V-Comics (Versailles Intention Attribution Task), and QCAE. Sensitivity to change was acceptable for the TREF. The TREF and V-SIR showed a cross-sectional relationship with functioning beyond the clinical symptoms of schizophrenia but not beyond neurocognition. Moreover, the TREF and V-SIR at inclusion could not predict functioning one year later, whereas most neurocognitive and clinical dimensions at inclusion could. Finally, only affective QCAE showed a significant cross-sectional, but not longitudinal, association with QoL. In conclusion, the TREF had satisfactory psychometric properties and showed a cross-sectional, but not longitudinal, association with objective outcome measures, thus appearing to be reliable in clinical practice and research. The V-SIR also showed promising psychometric properties, despite a possible weakness to detect change. However, these measures should be interpreted within the context of the good predictive power of the neurocognitive and clinical status on the outcome.

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Section: Discussionsupporting

confidence: 93%

Outcome prediction with a social cognitive battery: a multicenter longitudinal study

et al. 2021

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“…Of note, participants in the “Autistic schizophrenia” group showed greater functional impairment, both at the one-year and at the one-week assessment of the GAF: this result confirms the negative impact of ASD symptoms on functional outcomes of people living with schizophrenia, a fact already attested by studies conducted on larger samples of participants ( 19 – 21 ).…”

Section: Discussionsupporting

confidence: 75%

Autistic Symptoms in Schizophrenia: Impact on Internalized Stigma, Well-Being, Clinical and Functional Characteristics

et al. 2022

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Autism Spectrum Disorders (ASD) symptoms and internalized stigma (or self-stigma) can have a negative impact on cognitive and functional outcomes in people living with schizophrenia. Aim of the present study were to assess and compare internalized stigma, subjective well-being and other socio-demographic, clinical and functional characteristics in people diagnosed with schizophrenia with and without prominent autistic features. Ninety-four inpatients were assessed with measures of internalized stigma, subjective well-being, global clinical severity, schizophrenia symptoms severity, real-world functioning, medication side effects and attitude toward prescribed medications. Subjects with high levels of ASD symptoms were identified with the PANSS Autism Severity Score and compared to other participants. Predictors of prominent ASD features were also assessed. Thirteen patients showed prominent ASD symptoms. They were characterized by fewer years of education, worse real-world functioning and greater symptoms severity. No between-group differences were observed regarding subjective well-being and global internalized stigma severity; however, participants in the “autistic schizophrenia” group showed better stigma resistance. A worse clinical condition and fewer years of education emerged as predictors of autistic schizophrenia. Despite showing a more severe clinical presentation of the disorder and worse functional impairment, participants with prominent ASD symptoms do not present worse subjective well-being or more severe internalized stigma; on the contrary, they show better stigma resistance. ASD symptoms could therefore play a protective role in the internalization of stigma.

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“…Subsequent cross‐sectional studies have applied the PAUSS to adults with SCZ, and found that a higher PAUSS score was associated with greater impairment in social cognition (Deste, Vita, Penn, et al, 2020; Vita et al, 2020), social relationships (Deste, Vita, Nibbio, et al, 2020), and self‐reported everyday functioning (Harvey et al, 2019).…”

Section: Resultsmentioning

confidence: 99%

Autism spectrum disorder and schizophrenia: An updated conceptual review

2021

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Autism spectrum disorder (ASD) and schizophrenia (SCZ) are separate disorders, with distinct clinical profiles and natural histories. ASD, typically diagnosed in childhood, is characterized by restricted or repetitive interests or behaviors and impaired social communication, and it tends to have a stable course. SCZ, typically diagnosed in adolescence or adulthood, is characterized by hallucinations and delusions, and tends to be associated with declining function. However, youth with ASD are three to six times more likely to develop SCZ than their neurotypical counterparts, and increasingly, research has shown that ASD and SCZ converge at several levels. We conducted a systematic review of studies since 2013 relevant to understanding this convergence, and present here a narrative synthesis of key findings, which we have organized into four broad categories: symptoms and behavior, perception and cognition, biomarkers, and genetic and environmental risk. We then discuss opportunities for future research into the phenomenology and neurobiology of overlap between ASD and SCZ. Understanding this overlap will allow for researchers, and eventually clinicians, to understand the factors that may make a child with ASD vulnerable to developing SCZ. Lay Summary Autism spectrum disorder and schizophrenia are distinct diagnoses, but people with autism and people with schizophrena share several characteristics. We review recent studies that have examined these areas of overlap, and discuss the kinds of studies we will need to better understand how these disorders are related. Understanding this will be important to help us identify which autistic children are at risk of developing schizophrenia.

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

Cited by 31 publications

References 53 publications

Outcome prediction with a social cognitive battery: a multicenter longitudinal study

Outcome prediction with a social cognitive battery: a multicenter longitudinal study

Autistic Symptoms in Schizophrenia: Impact on Internalized Stigma, Well-Being, Clinical and Functional Characteristics

Autism spectrum disorder and schizophrenia: An updated conceptual review

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