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The Influence of Premorbid Adjustment and Autistic Traits on Social Cognitive Dysfunction in Schizophrenia

Published online by Cambridge University Press:  11 September 2019

Margherita Bechi Open the ORCID record for Margherita Bechi [Opens in a new window] ,
Giulia Agostoni ,
Mariachiara Buonocore ,
Francesca Bosinelli ,
Marco Spangaro ,
Laura Bianchi ,
Federica Cocchi ,
Carmelo Guglielmino ,
Roberto Cavallaro  and
Marta Bosia
Margherita Bechi*
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, 20100, Italy
Giulia Agostoni
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, 20100, Italy
Mariachiara Buonocore
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, 20100, Italy
Francesca Bosinelli
Affiliation:
School of Psychology, Vita-Salute San Raffaele University, Milan, 20100, Italy
Marco Spangaro
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, 20100, Italy
Laura Bianchi
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, 20100, Italy
Federica Cocchi
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, 20100, Italy
Carmelo Guglielmino
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, 20100, Italy
Roberto Cavallaro
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, 20100, Italy School of Medicine, Vita-Salute San Raffaele University, Milan, 20100, Italy
Marta Bosia
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, 20100, Italy School of Medicine, Vita-Salute San Raffaele University, Milan, 20100, Italy
*
*Correspondence and reprint requests to: Dr. Margherita Bechi, Department of Clinical Neurosciences, San Raffaele Scientific Institute, Via Stamira d’Ancona 20, Milano 20127, Italy, Tel. +390226433418, Fax. +390226433265. E-mail: bechi.margherita@hsr.it
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Abstract

Objectives:

Premorbid dysfunction during childhood and adolescence is well documented in patients with schizophrenia. Literature pointed out multiple premorbid trajectories leading to different patients’ cognitive status, symptomatology, and global functioning after disease onset. This study aimed at identifying groups of premorbid trajectories and disentangling between group differences in clinical and cognitive measures, focusing on theory of mind (ToM) and autistic traits (ATs).

Methods:

Ninety-seven patients with schizophrenia were recruited and assessed for cognitive and ToM abilities, psychopathology, and ATs. A two-step cluster analysis identified three different groups of patients based on premorbid adjustment during childhood, adolescence, and late adolescence (i.e., stable-good, stable-poor, and “deteriorating”).

Results:

Compared to 66 healthy controls, results showed a widespread impairment in cognitive and ToM abilities among all groups of patients, except for affective ToM and executive functions in the stable-good group. Moreover, the stable-poor group exhibited more pronounced ATs and a more severe ToM impairment, compared to the other two groups of patients.

Conclusions:

Our findings highlight the existence of a group of patients with poor premorbid adjustment since childhood, more pronounced ATs and a severe ToM impairment affecting those basic mentalizing skills that are usually preserved in schizophrenia. Results might have intriguing implications in identifying underpinning endophenotypes and implementing cutting-edge rehabilitation programs.

Keywords

PsychosisPremorbid functioningTheory of mindCognitionAutism spectrum disorderNeurodevelopmental disorders
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 26 , Issue 3 , March 2020 , pp. 276 - 285
Copyright
Copyright © INS. Published by Cambridge University Press, 2019

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Footnotes

†

These authors contributed equally to this work.

References

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