Cognitive insight in first-episode psychosis: Exploring the complex relationship between executive functions and social cognition

Abstract

Social cognition (SC) and executive function (EF) have been described as important variables for social functioning and recovery of patients with psychosis. However, the relationship between SC and EF in first-episode psychosis (FEP) deserves further investigation, especially focusing on gender differences.

Aims: To investigate the relationship between EF and different domains of SC in FEP patients and to explore gender differences in the relationship between these domains.

Methods: A cross-sectional study of 191 patients with new-onset psychosis recruited from two multicenter clinical trials. A comprehensive cognitive battery was used to assess SC (Hinting Task, Face Test and IPSAQ) and EF (TMT, WSCT, Stroop Test and digit span - WAIS-III). Pearson correlations and linear regression models were performed.

Results: A correlation between Theory of Mind (ToM), Emotional Recognition (ER) and EF was found using the complete sample. Separating the sample by gender showed different association profiles between these variables in women and men.

Conclusions: A relationship between different domains of SC and EF is found. Moreover, women and men presented distinct association profiles between EF and SC. These results should be considered in order to improve the treatment of FEP patients and designing personalized interventions by gender.

Keywords: Cognition; Emotional Recognition; Executive functions; First-episode psychosis; Psychosis; Social cognition; Theory of Mind.