Longitudinal stability of social cognition in schizophrenia: A 5-year follow-up of social perception and emotion processing

Background Individuals with schizophrenia exhibit marked and disproportional impairment in social cognition, which is associated with their level of community functioning. However, it is unclear whether social cognitive impairment is stable over time, or if impairment worsens as a function of illness chronicity. Moreover, little is known about the longitudinal associations between social cognition and community functioning. Method Forty-one outpatients with schizophrenia completed tests of emotion processing (Mayer-Salovey-Caruso Emotional Intelligence Test, MSCEIT) and social perception (Relationships Across Domains, RAD) at baseline and approximately five years later. Stability of performance was assessed using paired t-tests and correlations. Longitudinal associations between social cognition and community functioning (Role Functioning Scale, RFS) were assessed using cross-lagged panel correlation analysis. Results Performance on the two social cognition tasks were stable over follow-up. There were no significant mean differences between assessment points [p's ≥ 0.20, Cohen ' s d ' s ≤ | 0.20 |], and baseline performance was highly correlated with performance at follow-up [ρ's ≥ 0.70, ICC ≥ 0.83, p's < 0.001]. The contemporaneous association between social cognition and community functioning was moderately large at follow-up [ρ = 0.49, p = 0.002]. However, baseline social cognition did not show a significant longitudinal influence on follow-up community functioning [z = 0.31, p = 0.76]. Conclusions These data support trait-like stability of selected areas of social cognition in schizophrenia. Cross-lagged correlations did not reveal a significant unidirectional influence of baseline social cognition on community functioning five years later. However, consistent with the larger literature, a moderately large cross-sectional association between social cognition and community functioning was observed. Based on stability and cross-sectional associations, these results suggest that social cognition might have short-term implications for functional outcome rather than long-term consequences.