Social cognition, interpersonal distress, and functional outcomes in schizophrenia

Previous research has consistently shown links between personal and social difficulties and functional deficits in schizophrenia and related disorders. However, contemporary treatments for schizophrenia do not adequately consider interpersonal theory, despite its roots in successful schizophrenia treatment (Sullivan, 1962). The present study integrated interpersonal psychology with social cognitive research in order to better account for global functioning in schizophrenic outpatients. A targeted sample of 80 participants diagnosed with schizophrenia or schizoaffective disorder were recruited from a state hospital outpatient clinic and assessed for positive and negative symptoms, social cognition, interpersonal distress, and functional outcomes. Results showed partial support for the main hypotheses identifying negative symptoms as predictive of poor social cognition as well as functional outcomes. Surprisingly, better social cognition was predictive of more interpersonal problems, and individuals reporting more interpersonal problems evidenced better functional outcomes. The current study also found significant limitations with widely used assessment scales and encouraged the use of more objective, performance-based, as well as informant-rated measures in future research. Overall, the current findings have important implications for functional outcomes in schizophrenia, such that comprehensive psychological care must replace the existing culture of overreliance on pharmacotherapy in order to improve overall quality of life for schizophrenic outpatients.