Social Cognitive Impairments and Negative Symptoms in Schizophrenia: Are There Subtypes With Distinct Functional Correlates?

Social cognitive impairments and negative symptoms are core features of schizophrenia closely associated with impaired community functioning. However, little is known about whether these are independent dimensions of illness and if so, whether individuals with schizophrenia can be meaning-fully classified based on these dimensions (SANS) and poten-tially differentially treated. Five social cognitive measures plus Scale for the Assessment of Negative Symptoms (SANS) and Positive and Negative Syndrome Scale (PANSS) scores in a sample of 77 outpatients produced 2 dis-tinct factors—a social cognitive factor and a negative symp-tom factor. Factor scores were used in a cluster analysis, which yielded 3 well-defined groupings—a high negative symptom group (HN) and 2 low negative symptom groups, 1 with higher social cognition (HSC) and 1 with low social cognition (LSC). To make these findings more practicable for research and clinical settings, a rule of thumb for catego-rizing using only the Mayer–Salovey–Caruso Emotional In-telligence Test and PANSS negative component was created and produced 84.4 % agreement with the original cluster groups. An additional 63 subjects were added to cross validate the rule of thumb. When samples were combined (N 5 140), the HSC group had significantly better quality of life and Global Assessment of Functioning (GAF) scores, higher rates of marriage and more hospitalizations. The LSC group had worse criminal and substance abuse histories.With 2 common assessment instruments, people with schizophrenia can be classified into 3 subgroups that have different barriers to com-munity integration and could potentially benefit from different treatments. Key words: social cognition/negative syndrome/ community functioning/SANS/PANSS/MSCEI