Assessment of interrelationships between cognitive performance, symptomatic manifestation and social functioning in the acute and clinical stability phase of schizophrenia: Insights from a network analysis

Abstract

Abstract Background: It has been shown that various aspects of clinical manifestation of schizophrenia are strongly related to social functioning. However, it remains unknown as to whether similar factors predict social functioning at various stages of psychosis. Therefore, the present study aimed to compare the effects of interconnections between various domains of psychopathology and neurocognition on social functioning in people during acute phase of psychosis and those during remission of positive and disorganization symptoms using a network analysis. Methods: Two independent samples of individuals with schizophrenia spectrum disorders were enrolled (n = 208). Clinical assessment covered the levels of functioning, positive, negative and depressive symptoms. Cognition was recorded using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Results: Both networks did not differ significantly on the majority of network comparison tests, except of significantly higher strength centrality of negative symptoms in participants during clinical stability. In both networks, the majority of centrality metrics had the highest values for the RBANS attention score that is a sum of scores from two tasks (digit span and coding). In both networks, social functioning was directly connected to positive, negative and depressive symptoms as well as the RBANS scores of attention and language. Conclusions: Findings from the present study indicate the central role of cognitive deficits, especially those related to attention, processing speed, and working memory in shaping functional impairments regardless of schizophrenia phase. Therapeutic interventions that aim to improve functional capacity need to target these domains of neurocognitive performance.