Late-onset Schizophrenia Fosters Better Social Cognition

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Key clinical point: Older age at onset of schizophrenia was associated with better social cognition.

Major finding: Older patients showed better scores on measures of social cognition than did those with early-onset illness (r = 0.20; P < .016).

Data source: An analysis of 151 clinically stable schizophrenia patients from the mental health clinic at the Institute of Psychiatry and Neurology in Warsaw, Poland.

Disclosures: The study was sponsored by the National Science Center, Poland.




Older age of illness onset in schizophrenia patients is associated with better social competence, according to results of a recent study.

In an analysis of schizophrenia patients in a Warsaw mental health clinic, older age was associated with better performance on measures of social cognition, though it also was associated with slower performance in processing speed, problem solving, and attention, wrote Magdalena Linke and her colleagues at the Institute of Psychiatry and Neurology in Warsaw (Psychiatry Res. 2015;225:197-201).

The investigators studied 151 patients, aged 18 to 59 years, who met ICD-10 diagnostic criteria for schizophrenia at the Institute of Psychiatry and Neurology’s mental health clinic in Warsaw. Participants did not meet criteria for other psychiatric ICD-10 diagnoses, neurologic disorders that could affect cognitive function, history of head injury, or substance abuse. Patients were on stable doses of antipsychotic medications for at least 4 weeks at baseline.

Patient demographic and disease data were collected via interviews, and the Positive and Negative Syndrome Scale (PANSS) was completed for participants. Age at illness onset ranged from 12.5 years to 50.4 years, with a mean onset age of 23.1 years.

After assessment of participants’ cognitive function and psychiatric symptoms, cognition was evaluated using a Polish translation of the MATRICS Consensus Cognitive Battery (MCCB), which measures cognitive function in the areas of processing speed, working memory, problem solving, visual and verbal learning, social cognition, and attention.

Older age was associated with better scores in social cognition (r = 0.20; P = .016), as measured by the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) component of the MCCB, reported Ms. Linke, a PhD student, and her associates.

Older patients had slower performance on tests of processing speed (r = 0.21; P = .011), reasoning and problem solving (r = –0.28; P = .001), visual learning (r = –0.27; P = .001), and attention and vigilance (r = –0.20; P = .016), the authors said. Younger age was associated with better problem-solving performance and lower social cognition scores.

The results of this study “demonstrate that age at onset of schizophrenia might be an important factor altering social cognition in individuals with schizophrenia,” the authors said in the report. In light of these findings, cognitive remediation programs should be available to schizophrenia patients to help prevent cognitive decline, particularly in those at high risk for psychosis, they added.

The primary limitation of this study is a lack of healthy controls, which means conclusions cannot be made about whether age-related cognitive decline is accelerated in schizophrenia patients, the investigators said.

The study was funded by the National Science Center, Poland. The authors did not report any additional disclosures.

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