The Influence of Premorbid Adjustment and Autistic Traits on Social Cognitive Dysfunction in Schizophrenia

Premorbid dysfunction during childhood and adolescence is well documented in patients with schizophrenia. Literature pointed out multiple premorbid trajectories leading to different patients' cognitive status, symptomatology, and global functioning after disease onset. This study aimed at ident...

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Bibliographic Details
Published in:Journal of the International Neuropsychological Society 2020-03, Vol.26 (3), p.276-285
Main Authors: Bechi, Margherita, Agostoni, Giulia, Buonocore, Mariachiara, Bosinelli, Francesca, Spangaro, Marco, Bianchi, Laura, Cocchi, Federica, Guglielmino, Carmelo, Cavallaro, Roberto, Bosia, Marta
Format: Article
Language:English
Subjects:
Adjustment
Adolescents
Autism
Child development
Children
Cognition
Cognition & reasoning
Cognitive ability
Educational attainment
Illnesses
Memory
Mental disorders
Psychopathology
Questionnaires
Rehabilitation
Schizophrenia
Studies
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Summary:Premorbid dysfunction during childhood and adolescence is well documented in patients with schizophrenia. Literature pointed out multiple premorbid trajectories leading to different patients' cognitive status, symptomatology, and global functioning after disease onset. This study aimed at identifying groups of premorbid trajectories and disentangling between group differences in clinical and cognitive measures, focusing on theory of mind (ToM) and autistic traits (ATs). Ninety-seven patients with schizophrenia were recruited and assessed for cognitive and ToM abilities, psychopathology, and ATs. A two-step cluster analysis identified three different groups of patients based on premorbid adjustment during childhood, adolescence, and late adolescence (i.e., stable-good, stable-poor, and "deteriorating"). Compared to 66 healthy controls, results showed a widespread impairment in cognitive and ToM abilities among all groups of patients, except for affective ToM and executive functions in the stable-good group. Moreover, the stable-poor group exhibited more pronounced ATs and a more severe ToM impairment, compared to the other two groups of patients. Our findings highlight the existence of a group of patients with poor premorbid adjustment since childhood, more pronounced ATs and a severe ToM impairment affecting those basic mentalizing skills that are usually preserved in schizophrenia. Results might have intriguing implications in identifying underpinning endophenotypes and implementing cutting-edge rehabilitation programs.
ISSN:1355-6177
1469-7661
DOI:10.1017/S1355617719000961