Mediation Effects of Social Cognition on the Relationship between Neurocognition and Social Functioning in Major Depressive Disorder and Schizophrenia Spectrum Disorders

Abstract

Background: In schizophrenia spectrum disorders (SSD), social cognition mediates the relationship between neurocognition and social functioning. Although people with major depressive disorder (MDD) also exhibit cognitive impairments, which are often prolonged, little is known about the role of social cognition in MDD. Methods: Using data obtained through an internet survey, 210 patients with SSD or MDD were selected using propensity score matching based on their demographics and illness duration. Social cognition, neurocognition, and social functioning were evaluated using the Self-Assessment of Social Cognition Impairments, Perceived Deficits Questionnaire, and Social Functioning Scale, respectively. The mediation effects of social cognition on the relationship between neurocognition and social functioning were examined in each group. Invariances of the mediation model across the two groups were then analyzed. Results: The SSD and MDD groups had mean ages of 44.49 and 45.35 years, contained 42.0% and 42.8% women, and had mean illness durations of 10.76 and 10.45 years, respectively. In both groups, social cognition had significant mediation effects. Configural, measurement, and structural invariances across the groups were established. Conclusion: The role of social cognition in patients with MDD was similar to that in SSD. Social cognition could be a common endophenotype for various psychiatric disorders.

Negative symptoms and social cognition as mediators of the relationship between neurocognition and functional outcome in schizophrenia

“…Our results are broadly consistent with previous literature showing a relationship between psychopathology, neurocognition and social cognition with functional outcome ( 4 – 6 , 9 , 15 , 49 , 63 , 65 , 67 , 73 , 76 , 87 – 89 ). In particular, as regard to positive symptoms, even when they are of subclinical severity (mild severity in our sample), might contribute to global functioning.…”

“…In summary, the evidence accumulated emphasizes the central role of neurocognition, negative symptoms, and social cognition as primary determinants of functional outcome in individuals with schizophrenia. Notably, as explained above, both negative symptoms and deficits in social cognition seem to mediate the relationships between neurocognition and functioning in patients with schizophrenia and even in the early stages of the disease (42,47,48,(64)(65)(66)(67).…”

“…According to other studies, it acts as a mediator between the latter and functional outcome (4-6, 15, 45-47, 59, 63-67), and between specific neurocognitive domains, such as processing speed (65), sustained attention (65) and verbal memory (64) and functional outcome. Social perception has been reported as a mediator between early visual processing and functional outcome (66), ToM as mediator between neurocognition and social competence that, in turn, showed a direct link with self-reported functioning (63), while emotion recognition was found to be a mediator between neurocognition and social functioning in people with schizophrenia and first episode psychoses (68).…”

Deficits in Key Brain Network for Social Interaction in Individuals with Schizophrenia

“…The decline in social functioning among individuals with SZ is closely related to deficits in social cognition [10,11]. Representative domains of social cognition encompass the theory of mind, social perception, emotion processing and attributional style/bias [12].…”