Deficits in social cognition in first episode psychosis: A review of the literature

- First episode psychosis (FEP) individuals evidence impaired social cognition (SC).
- FEP deficits in emotion perception (EP) and theory of mind (ToM).
- Less research concerning FEP social perception (SP) and attributional style (AS).
- Individuals with FEP and established schizophrenia show comparable SC deficits.
- SC deficits in FEP appear to be stable over time, associated with positive/negative symptoms.

ObjectiveIndividuals with chronic schizophrenia (SCZ) consistently show impairments in social cognition (SC) that are associated with functional decline, and work suggests that similar associations exist in first-episode psychosis (FEP). The goal of the current article is to review and synthesize the current body of work examining SC in FEP. Secondary aims are to examine the relationship between SC and symptoms, and change in SC over time in FEP.DesignLiterature is reviewed from four key SC domains: emotion processing (EP), theory of mind (ToM), social perception (SP), and attributional style (AS). Targeted searches of PsycINFO and Google Scholar were conducted to identify relevant manuscripts.ResultsData from 48 relevant studies (6 longitudinal) were reviewed and integrated.Conclusions(1) FEP individuals show consistent deficits in SC compared to healthy controls, most consistently in EP (particularly, fear and sadness recognition) and ToM compared to SP and AS, (2) individuals with FEP and SCZ show comparable SC deficits, (3) some evidence indicates SC deficits in FEP are associated with negative and positive symptoms, and (4) SC appears to be stable over time in FEP.