Social Cognition Deficits as a Target of Early Intervention for Psychoses: A Systematic Review

Abstract

Backgrounds: Social cognition deficits are a core feature of schizophrenia and deteriorate functionality of patients. However, evidence is sparse for the treatment effect on social cognition impairments in the early stage of psychosis. Here, we provide a systematic review of the literature on social cognitive impairment in early psychosis in relation to its intervention. Methods: A literature search was conducted on English articles identified by Web of Science and PubMed databases, according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Results: Five papers met the inclusion criteria. Results from two studies of cognitive training and one study of modafinil indicate positive results regarding social cognition outcomes in patients with early psychosis. On the other hand, two studies with oxytocin and modafinil did not suggest such effects. Conclusions: Further research is warranted to explore the benefit of early intervention into disturbances of social cognition in psychoses.

Keywords: at risk mental state; emotion recognition; first-episode psychosis; randomized controlled trial; schizophrenia; theory of mind; ultra-high risk.

Figure 1

Study selection flowchart, following the guidelines of the PRISMA statement. Initially, titles and abstracts were screened to identify eligible studies. Full-text articles were obtained for all the studies considered compatible, based on the abstract screening, and were further reviewed for eligibility.

Figure 2

Assessment of risk of bias for included studies, based on the Cochrane Collaboration’s risk of bias tool. We determined whether each trial had a low, high, or uncertain risk of bias in terms of random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data, selective reporting, and other biases.