The predictive value of measures of social cognition for community functioning in schizophrenia: implications for neuropsychological assessment.

The objective of this study was to examine the unique contribution of social cognition to the prediction of community functioning and to explore the relevance of social cognition for clinical practice. Forty-six schizophrenia patients and 53 healthy controls were assessed with tests of social cognition [emotion perception and Theory of Mind (ToM)], general cognition, and, within the patient sample, psychiatric symptoms. Community functioning was rated by nurses or family members. Social cognition was a better predictor of community functioning than general cognition or psychiatric symptoms. When the contributions of emotion perception and ToM were examined separately, only ToM contributed significantly to the prediction of community functioning. Independent living skills were poor in patients with impaired social cognition. In controls, social cognition was not related to community functioning. ToM was the best predictor of community functioning in schizophrenia. However, to fully understand a patient's strengths and weaknesses, assessment of social cognition should always be combined with assessment of general cognition and psychiatric symptoms.