Social Withdrawal and Neurocognitive Correlates in Schizophrenia

Abstract Background: Social withdrawal constitutes a clinical manifestation of social dysfunction in SCZ that has a high impact on the quality of life of patients. Poor neurocognitive performance has been associated with poor functional outcome in SCZ in past studies. Nonetheless, the likely association between neurocognition and social withdrawal has never been investigated. The aim of our study was to investigate in a large and heterogeneous sample of SCZ patients cross-sectional associations between neurocognitive domains and social withdrawal. Methods: The sample included 761 SCZ patients who completed the baseline visit in the CATIE study. Neurocognition was assessed by a comprehensive battery of tests resulting in 5 domain scores and a composite score. Social withdrawal was measured by a specific item of the Heinrichs-Carpenter Quality of Life Scale. Bivariate correlations, ANOVA and multiple regression analysis were conducted using STATISTICA software package (StatSoft, Inc. Tulsa, OK, USA). Statistical significance was tested at p value < 0.05. Results: Social withdrawal was associated with a lower score in the neurocognitive composite score and in “Verbal memory”, “Processing speed” and “Working memory” scores. “Verbal memory” score showed the strongest association with social withdrawal. 8% of the total variance of social withdrawal was explained by these three cognitive domains and additional clinical and socio-demographic factors (education years, PANSS positive symptoms score, employment). Conclusions: Our study showed that in a large and real-world representative sample of SCZ patients, social withdrawal was associated with neurocognitive deficits involving verbal memory, processing speed and working memory domains. Our results confirmed the wide heterogeneity and specificity of the correlation between neurocognitive domains and indicators of functional outcome in SCZ, underlining the role of certain neurocognitive abilities in social withdrawal.