Does Schizophrenia Subtype Affect Social Cognition?

In a poster presented at the American Psychiatric Association 2023 Annual Meeting, investigators compared social cognitive profiles between three clinical subtypes of schizophrenia, as well as prognoses, treatments, and clinical characteristics. The subtypes were defined by clinical response: treatment-responsive (TRpS), treatment-resistant (TRS), and ultra-treatment-resistant schizophrenia (UTRS).

The study, presented by Seung Ho Lee, found adult patients with schizophrenia overall were more likely to show blame biases in Ambiguous scenarios compared with Accidental scenarios based on self-reported Blame Scores on the Ambiguous Intentions Hostility Questionnaire (AIHQ). Notably, patients with UTRS showed higher overall biases compared with patients with TRpS.

The study enrolled 85 English-speaking patients (mean age, 45.2 years; 70.6% male) from an outpatient schizophrenia clinic. Clinical subtypes were assigned according to the treatment used: non-clozapine antipsychotics in the TRpS group, clozapine monotherapy in the TRS group, and clozapine plus additional therapies is the UTRS group.

Social cognitive defects were assessed by AIHQ responses, and demographic, diagnosis, substance use, medication use, and comorbidity data were obtained from electronic medical records. Treating psychiatrists completed Clinical Global Impression scales to control for the severity of symptoms.

After omitting five incomplete responses, patients with schizophrenia had a Blame Score in Ambiguous situations ranging from 3.0 to 13.8, compared with 5.1 to 5.4 in the general population, according to the report.

The UTRS group (n=18; mean age, 41 years; 66.7% male) had a mean Ambiguous Blame Score of 6.38 and Accidental Blame Score of 6.62, while the TRpS group (n=58; mean age, 45.5 years; 74.1% male) had mean Ambiguous and Accidental Blame Scores of 7.270 and 5.941, respectively (P<.05). Authors noted the TRS group (n=4; mean age, 55 years; 50% male) was too small for analysis.

In closing, researchers reported their overall findings on social cognitive profiles in patients with schizophrenia and, given the differences between clinical subtypes, suggested there may be “distinguishable pathophysiology in the socio-cognitive domain.” Source:,%20May%2021,%202023