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

Abstract

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.

Fig. 1. ß standardized coefficients of simple cross-sectional regressions of functioning (PSP) and quality of life (S-QoL) on various social cognition variables at inclusion.

TREF, Test de Reconnaissance des Émotions Faciales—Facial Emotion Recognition Test, V-Comics: Versailles Intention Attribution Task, SPEX-GA & BA: Social cognition, Perception, eXecutive functions—Belief & Goal Attribution sensitivities, QCAE Cog: Questionnaire of Cognitive and Affective, QCAE aff: Questionnaire of Cognitive and Affective Empathy—Affective empathy subscore Empathy—Cognitive empathy subscore, V-SIR: Versailles Situational Intention Reading. The signs of ß were reversed for V-SIR.

Fig. 2. ß standardized coefficients of simple regressions of functioning (PSP) and quality of life (S-QoL) at follow-up on various social cognition measures at inclusion.

Legends: please see Fig. 1.