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Comparison of social cognition using an adapted Chinese version of the Reading the Mind in the Eyes Test in drug-naive and regularly medicated individuals with chronic schizophrenia and healthy controls in rural China

Published online by Cambridge University Press:  16 March 2021

Fei Deng ,
Michael R. Phillips Open the ORCID record for Michael R. Phillips [Opens in a new window] ,
Bing Cai ,
Gary Yu ,
Min Qian ,
Margaux M.R. Grivel ,
Hanhui Chen ,
Xinyi Ouyang ,
Fang Xue  and
Mingru Zhao
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Fei Deng
Affiliation:
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China University of Nottingham School of Economics (Ningbo, China), Zhejiang, China
Michael R. Phillips*
Affiliation:
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA Department of Psychiatry, Columbia University, New York, New York, USA New York State Psychiatric Institute, New York, New York, USA
Bing Cai
Affiliation:
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Gary Yu
Affiliation:
New York University Rory Meyers College of Nursing, New York, New York, USA
Min Qian
Affiliation:
Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York, USA
Margaux M.R. Grivel
Affiliation:
New York University School of Global Public Health, New York, New York, USA
Hanhui Chen
Affiliation:
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Xinyi Ouyang
Affiliation:
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Fang Xue
Affiliation:
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Mingru Zhao
Affiliation:
Xiangya School of Public Health, Central South University, Changsha, Hunan, China
Lawrence S. Kegeles
Affiliation:
Department of Psychiatry, Columbia University, New York, New York, USA New York State Psychiatric Institute, New York, New York, USA
Ezra S. Susser
Affiliation:
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA New York State Psychiatric Institute, New York, New York, USA
Matcheri S. Keshavan
Affiliation:
Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
William S. Stone
Affiliation:
Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
Lawrence H. Yang
Affiliation:
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA New York University School of Global Public Health, New York, New York, USA
*
Author for correspondence: Michael R. Phillips, E-mail: mphillipschina@outlook.com
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Abstract

Background

Social cognition has not previously been assessed in treatment-naive patients with chronic schizophrenia, in patients over 60 years of age, or in patients with less than 5 years of schooling.

Methods

We revised a commonly used measure of social cognition, the Reading the Mind in the Eyes Test (RMET), by expanding the instructions, using both self-completion and interviewer-completion versions (for illiterate respondents), and classifying each test administration as ‘successfully completed’ or ‘incomplete’. The revised instrument (RMET-CV-R) was administered to 233 treatment-naive patients with chronic schizophrenia (UT), 154 treated controls with chronic schizophrenia (TC), and 259 healthy controls (HC) from rural communities in China.

Results

In bivariate and multivariate analyses, successful completion rates and RMET-CV-R scores (percent correct judgments about emotion exhibited in 70 presented slides) were highest in HC, intermediate in TC, and lowest in UT (adjusted completion rates, 97.0, 72.4, and 49.9%, respectively; adjusted RMET-CV-R scores, 45.4, 38.5, and 34.6%, respectively; all p < 0.02). Stratified analyses by the method of administration (self-completed v. interviewer-completed) and by education and age (‘educated-younger’ v. ‘undereducated-older’) show the same relationship between groups (i.e. NC>TC>UT), though not all differences remain statistically significant.

Conclusions

We find poorer social cognition in treatment-naive than in treated patients with chronic schizophrenia. The discriminant validity of RMET-CV-R in undereducated, older patients demonstrates the feasibility of administering revised versions of RMET to patients who may otherwise be considered ineligible due to education or age by changing the method of test administration and carefully assessing respondents' ability to complete the task successfully.

Keywords

Chinalow- and middle-income countries (LMIC)Reading the Mind in the Eyes Test (RMET)schizophreniasocial cognition
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 15 , November 2022 , pp. 3655 - 3667
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

*

Senior authorship is shared equally between Dr Yang and Dr Phillips.

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