Schizophrenia, autism spectrum disorders have similar social cognitive impairment levels

Individuals with schizophrenia spectrum disorders or autism spectrum disorders may have similar levels of social cognitive impairment, according to study results published in JAMA Psychiatry.

“Although historically few studies have included both diagnostic groups, cross-disorder research on social cognition in people with [these disorders] is increasing because of a shift toward transdiagnostic research, use of the Research Domain Criteria framework and the prioritization of improving functional outcome,” Lindsay D. Oliver, PhD, of the Campbell Family Mental Health Research Institute in Canada, and colleagues wrote.

According to the researchers, moving past diagnostic categories and characterization of social cognitive deficits may provide insights into shared pathways of these disorders. Oliver and colleagues searched four databases from inception until July 26 and included articles that measured performance of social cognition among schizophrenia spectrum disorder and autism spectrum disorder samples. They included articles published in English that used ICD-10, DSM-4 or more recent diagnostic criteria. Performance on emotion processing tasks, theory of mind (ToM) tasks and the Reading the Mind in the Eyes Tests (RMET) among the two cohort types served as the primary outcomes. The researchers performed meta-regressions for age difference, publication year, quality assessment scores and antipsychotic medication use.

The qualitative and quantitative analyses included 36 and 33 studies, respectively. Results showed a prevalence of small, male-predominant samples and a lack of cross-disorder clinical measures. Meta-analyses showed no statistically significant differences between schizophrenia spectrum disorders and autism spectrum disorders on emotion processing measures, ToM measures or the RMET. However, the researchers noted statistically significantly heterogeneous performance differences between studies for the disorder types, which potential moderators only minimally explained.

“These results highlight the need for cross-disorder studies of social cognition with larger samples, including adolescents, and consistent reporting of measures that may impact outcome,” Oliver and colleagues wrote. “Integrating data spanning multiple levels of analysis across [schizophrenia spectrum disorders and autism spectrum disorders] is a critical next step to identify associations that may delineate more homogeneous subgroups with similar etiology, treatment response and phenotypic characteristics.”