Section of Psychiatry, Department of Neuroscience, University of Turin, Turin, Italy.
Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
Eur Psychiatry. 2023 Jan 11;66(1):e10. doi: 10.1192/j.eurpsy.2022.2356.
Deficits in social cognition (SC) are significantly related to community functioning in schizophrenia (SZ). Few studies investigated longitudinal changes in SC and its impact on recovery. In the present study, we aimed: (a) to estimate the magnitude and clinical significance of SC change in outpatients with stable SZ who were assessed at baseline and after 4 years, (b) to identify predictors of reliable and clinically significant change (RCSC), and (c) to determine whether changes in SC over 4 years predicted patient recovery at follow-up.
The reliable change index was used to estimate the proportion of true change in SC, not attributable to measurement error. Stepwise multiple logistic regression models were used to identify the predictors of RCSC in a SC domain (The Awareness of Social Inference Test [TASIT]) and the effect of change in TASIT on recovery at follow-up.
In 548 participants, statistically significant improvements were found for the simple and paradoxical sarcasm of TASIT scale, and for the total score of section 2. The reliable change index was 9.8. A cut-off of 45 identified patients showing clinically significant change. Reliable change was achieved by 12.6% and RCSC by 8% of participants. Lower baseline TASIT sect. 2 score predicted reliable improvement on TASIT sect. 2. Improvement in TASIT sect. 2 scores predicted functional recovery, with a 10-point change predicting 40% increase in the probability of recovery.
The RCSC index provides a conservative way to assess the improvement in the ability to grasp sarcasm in SZ, and is associated with recovery.
社交认知（SC）缺陷与精神分裂症（SZ）患者的社区功能显著相关。很少有研究调查 SC 的纵向变化及其对康复的影响。本研究旨在：（a）评估基线和 4 年后稳定 SZ 门诊患者 SC 的变化幅度和临床意义；（b）确定可靠和临床显著变化（RCSC）的预测因素；（c）确定 4 年内 SC 变化是否预测随访时患者的康复。
采用可靠变化指数估计 SC 变化中真实变化的比例，而不是归因于测量误差。逐步多元逻辑回归模型用于识别 TASIT（社会推理测试的意识）领域中 RCSC 的预测因素以及 TASIT 变化对随访时康复的影响。
在 548 名参与者中，TASIT 量表的简单和矛盾讽刺以及第 2 节的总分均有统计学意义上的改善。可靠变化指数为 9.8。45 的截点确定了表现出临床显著变化的患者。12.6%的参与者和 8%的参与者实现了可靠的改善。较低的 TASIT 第 2 节基线得分预测 TASIT 第 2 节可靠的改善。TASIT 第 2 节分数的提高预测了功能的恢复，10 分的变化预测了康复概率增加 40%。
RCSC 指数为评估 SZ 患者理解讽刺的能力提供了一种保守的方法，与康复相关。
