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Background <p>Schizophrenia significantly impacts all domains of life, and its potential prodromal stage, Clinical High Risk for Psychosis (CHR-P), has gained attention for the opportunity to enhance prognosis through early intervention. Consequently, recent studies have concentrated on identifying cognitive deficits associated with CHR-P and correlations with symptom severity.</p> Aim <p>To assess Theory of Mind (ToM) as a component of Social Cognition (SC), and Metacognition (MC), in family relatives (FRs) of schizophrenia patients—half of whom met criteria for a current CHR-P state—compared with unaffected FRs and healthy controls. Associations between SC/MC deviations and prodromal symptoms were also examined.</p> Method <p>This case–control research comprised 96 participants, aged 18–45, recruited from Cairo University Hospitals over 21 months. 64 were relatives of schizophrenia patients; 32 of these relatives met current CHR-P criteria according to the Structured Interview for Prodromal Syndromes (SIPS). None of the relatives had current or past psychotic disorders. 32 matched healthy controls were also recruited. Axis-I psychiatric disorders were excluded using SCID-I. Participants completed the SIPS, Reading the Mind in the Eyes Test (RMET), and Metacognition Questionnaire-30 (MCQ-30).</p> Results <p>RMET scores were significantly lower in the CHR and FR Not at CHR groups than in the controls (<i>p</i> &lt; 0.001 and <i>p</i> = 0.001, respectively). In contrast, CHR participants exhibited significantly higher MCQ-30 scores (indicating greater maladaptive metacognitive beliefs) than both controls (<i>p</i> &lt; 0.001) and FR Not at CHR (<i>p</i> = 0.021). FR Not at CHR, however, did not differ significantly from controls regarding MC. A significant discrepancy was observed in the CHR group in MCQ-30 subscales "Negative Beliefs about Uncontrollability and Danger" and "Need to Control Thoughts" (<i>p</i> &lt; 0.001). The MCQ-30 total score and the SIPS general symptoms subscale were positively correlated (<i>p</i> = 0.013, r = 0.435) exclusively in the FR Not at CHR group.</p> Conclusion <p>Poorer ToM performance is present in CHR individuals as well as unaffected relatives of schizophrenia patients. Conversely, greater MC difficulties emerged with prodromal symptoms. This pattern could hypothetically suggest SC difficulties as trait marker whereas MC alterations being rather state-dependent. Further large-scale and longitudinal studies are warranted to determine these trait-state distinctions.</p>

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Social cognition and metacognition in family relatives of schizophrenia patients: comparing those with and without a current clinical high-risk state for psychosis

  • 期刊论文

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  • 发表日期：

    2025年12月22日

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  • Yasmine M. Gaafar,
  • Hanan A. ElShinnawy,
  • Mai Abdel Samie

摘要

Background

Schizophrenia significantly impacts all domains of life, and its potential prodromal stage, Clinical High Risk for Psychosis (CHR-P), has gained attention for the opportunity to enhance prognosis through early intervention. Consequently, recent studies have concentrated on identifying cognitive deficits associated with CHR-P and correlations with symptom severity.

Aim

To assess Theory of Mind (ToM) as a component of Social Cognition (SC), and Metacognition (MC), in family relatives (FRs) of schizophrenia patients—half of whom met criteria for a current CHR-P state—compared with unaffected FRs and healthy controls. Associations between SC/MC deviations and prodromal symptoms were also examined.

Method

This case–control research comprised 96 participants, aged 18–45, recruited from Cairo University Hospitals over 21 months. 64 were relatives of schizophrenia patients; 32 of these relatives met current CHR-P criteria according to the Structured Interview for Prodromal Syndromes (SIPS). None of the relatives had current or past psychotic disorders. 32 matched healthy controls were also recruited. Axis-I psychiatric disorders were excluded using SCID-I. Participants completed the SIPS, Reading the Mind in the Eyes Test (RMET), and Metacognition Questionnaire-30 (MCQ-30).

Results

RMET scores were significantly lower in the CHR and FR Not at CHR groups than in the controls (p < 0.001 and p = 0.001, respectively). In contrast, CHR participants exhibited significantly higher MCQ-30 scores (indicating greater maladaptive metacognitive beliefs) than both controls (p < 0.001) and FR Not at CHR (p = 0.021). FR Not at CHR, however, did not differ significantly from controls regarding MC. A significant discrepancy was observed in the CHR group in MCQ-30 subscales "Negative Beliefs about Uncontrollability and Danger" and "Need to Control Thoughts" (p < 0.001). The MCQ-30 total score and the SIPS general symptoms subscale were positively correlated (p = 0.013, r = 0.435) exclusively in the FR Not at CHR group.

Conclusion

Poorer ToM performance is present in CHR individuals as well as unaffected relatives of schizophrenia patients. Conversely, greater MC difficulties emerged with prodromal symptoms. This pattern could hypothetically suggest SC difficulties as trait marker whereas MC alterations being rather state-dependent. Further large-scale and longitudinal studies are warranted to determine these trait-state distinctions.