TY - JOUR

T1 - A Systematic Review and Meta-Analysis of the Association Between Psychopathology and Social Functioning in Schizophrenia

AU - Handest, Rasmus Dan

AU - Mølstrøm, Ida-Marie

AU - Henriksen, Mads Gram

AU - Hjorthøj, Carsten

AU - Nordgaard, Julie

PY - 2023

Y1 - 2023

N2 - BackgroundImpaired social functioning is a major, but under-elucidated area of schizophrenia. It’s typically understood as consequential to, eg, negative symptoms, but meta-analyses on the subject have not examined psychopathology in a broader perspective and there’s severe heterogeneity in outcome measures. To enhance functional recovery from schizophrenia, a more comprehensive understanding of the nature of social functioning in schizophrenia is needed.Study DesignIn this systematic review and meta-analysis, we searched PubMed, PsycInfo, and Ovid Embase for studies providing an association between psychopathology and social functioning. Meta-analyses of the regression and correlation coefficients were performed to explore associations between social functioning and psychopathology, as well as associations between their subdomains.Study ResultsThirty-six studies with a total of 4742 patients were included. Overall social functioning was associated with overall psychopathology (95% CI [−0.63; −0.37]), positive symptoms (95% CI [−0.39; −0.25]), negative symptoms (95% CI [−0.61; -0.42]), disorganized symptoms (95% CI [−0.54; −0.14]), depressive symptoms (95% CI [−0.33; −0.11]), and general psychopathology (95% CI [−0.60; −0.43]). There was significant heterogeneity in the results, with I2 ranging from 52% to 92%.ConclusionsThis is the first systematic review and meta-analysis to comprehensively examine associations between psychopathology and social functioning. The finding that all psychopathological subdomains seem to correlate with social functioning challenges the view that impaired social functioning in schizophrenia is mainly a result of negative symptoms. In line with classical psychopathological literature on schizophrenia, it may be more appropriate to consider impaired social functioning as a manifestation of the disorder itself.

AB - BackgroundImpaired social functioning is a major, but under-elucidated area of schizophrenia. It’s typically understood as consequential to, eg, negative symptoms, but meta-analyses on the subject have not examined psychopathology in a broader perspective and there’s severe heterogeneity in outcome measures. To enhance functional recovery from schizophrenia, a more comprehensive understanding of the nature of social functioning in schizophrenia is needed.Study DesignIn this systematic review and meta-analysis, we searched PubMed, PsycInfo, and Ovid Embase for studies providing an association between psychopathology and social functioning. Meta-analyses of the regression and correlation coefficients were performed to explore associations between social functioning and psychopathology, as well as associations between their subdomains.Study ResultsThirty-six studies with a total of 4742 patients were included. Overall social functioning was associated with overall psychopathology (95% CI [−0.63; −0.37]), positive symptoms (95% CI [−0.39; −0.25]), negative symptoms (95% CI [−0.61; -0.42]), disorganized symptoms (95% CI [−0.54; −0.14]), depressive symptoms (95% CI [−0.33; −0.11]), and general psychopathology (95% CI [−0.60; −0.43]). There was significant heterogeneity in the results, with I2 ranging from 52% to 92%.ConclusionsThis is the first systematic review and meta-analysis to comprehensively examine associations between psychopathology and social functioning. The finding that all psychopathological subdomains seem to correlate with social functioning challenges the view that impaired social functioning in schizophrenia is mainly a result of negative symptoms. In line with classical psychopathological literature on schizophrenia, it may be more appropriate to consider impaired social functioning as a manifestation of the disorder itself.

U2 - 10.1093/schbul/sbad075

DO - 10.1093/schbul/sbad075

M3 - Review

C2 - 37260350

VL - 49

SP - 1470

EP - 1485

JO - Schizophrenia Bulletin

JF - Schizophrenia Bulletin

SN - 0586-7614

IS - 6

ER -