In a groundbreaking study published in the Spanish Journal of Psychiatry and Mental Health on January 25, 2024, researchers have delved into the enigmatic relationship between two key cognitive domains – social cognition (SC) and executive function (EF) – in individuals experiencing their first episode of psychosis. Notably, the investigation, spearheaded by a team from various Spanish institutions, also addresses the intriguing variance of this relationship across genders.
Psychosis, a mental health condition characterized by disruptions in perception and understanding, often emerges with a first episode that signals the onset of the illness. Understanding its cognitive aspects enhances clinicians’ ability to formulate effective treatment strategies. Cognitive insight, an individual’s ability to re-evaluate and correct erroneous beliefs and judgment, is essential for patients grappling with psychosis. It intertwines two critical cognitive components: social cognition – the ability to perceive and interpret social cues, and executive function – the brain’s command center for planning, attention, and problem-solving.
López-Carrilero and colleagues approached this study with a unique focus on the interaction between SC and EF in first-episode psychosis (FEP) patients, along with the exploration of gender-specific differences within this interaction (S2950-2853(24)00009-7, doi:10.1016/j.sjpmh.2024.01.002).
The study utilized a cross-sectional design, encompassing 191 patients with newly identified psychosis from two multi-center clinical trials. Each participant underwent an exhaustive cognitive battery of tests to measure SC (using the Hinting Task, Face Test, and IPSAQ) and EF (using the Trail Making Test (TMT), Wisconsin Card Sorting Test (WSCT), Stroop Test, and digit span from the WAIS-III).
The research revealed significant correlations between the Theory of Mind (ToM), Emotional Recognition (ER), and executive functions across the pooled sample. Strikingly, when segregating the sample based on gender, the associations between SC and EF showcased distinct patterns for men and women, suggesting that gender plays a pivotal role in the cognitive architecture of psychosis.
These findings offer a novel lens through which personalized interventions can be tailored, considering the gender-specific cognitive interplay for those with first-episode psychosis. By pondering the distinct cognitive profiles, mental health practitioners can better direct their treatments, potentially enhancing recovery outcomes for patients.
Copyright for this crucial work is held by the Sociedad Española de Psiquiatría y Salud Mental (SEPSM) and published by Elsevier España S.L.U. The team of authors, led by Raquel R López-Carrilero, includes an array of respected researchers from several Spanish institutions, uniting experts across various related disciplines.
While this study is a notable stride in distinguishing the cognitive nuances in psychosis, it adds to the ever-evolving field of psychiatric research. Previous studies have consistently underscored the relevance of SC and EF in gauging social functioning and prognosis in psychosis, but the element of gender had not been rigorously scrutinized until now.
Keywords
1. First-episode psychosis cognitive insight
2. Social cognition executive functions
3. Gender differences psychosis
4. Cognitive profiles in psychosis
5. Psychosis social functioning recovery
References
1. López-Carrilero, R., Monaco, M. L., Frígola-Capell, E., Ferrer-Quintero, M., Díaz-Cutraro, L., … Ochoa, S. (2024). Cognitive insight in first-episode psychosis: Exploring the complex relationship between executive functions and social cognition. Spanish Journal of Psychiatry and Mental Health, S2950-2853(24)00009-7. https://doi.org/10.1016/j.sjpmh.2024.01.002
2. Green, M.F., Horan, W.P., & Lee, J. (2019). Social cognition in schizophrenia. Nature Reviews Neuroscience, 20(10), 620-637. https://doi.org/10.1038/s41583-019-0205-7
3. Heckers, S., & Barch, D. M. (2016). Psychopathology in schizophrenia: The Harvard View. Focus, 14(3), 277–283. https://doi.org/10.1176/appi.focus.140302
4. Pinkham, A.E., Penn, D.L., Green, M.F., & Harvey, P.D. (2016). Social Cognition Psychometric Evaluation: Results of the Initial Psychometric Study. Schizophrenia Bulletin, 42(2), 494-504. https://doi.org/10.1093/schbul/sbv056
5. Lesh, T. A., Niendam, T. A., Minzenberg, M. J., & Carter, C. S. (2011). Cognitive control deficits in schizophrenia: Mechanisms and meaning. Neuropsychopharmacology, 36(1), 316-338. https://doi.org/10.1038/npp.2010.156
Conclusion
This illuminating study offers a refined comprehension of how cognitive insight shapes the subjective experience of psychosis. Particularly, the gender-specific insights gleaned from the data enable us to envision more nuanced diagnostic and therapeutic avenues, ensuring that patients with FEP receive the most efficacious and individualized care possible. As research progresses, integrating such nuanced understandings could revolutionize our approach to mental health interventions.