跨越精神分裂症-躁郁症谱系的社会认知

IF 16.8 Q1 PSYCHOLOGY, MULTIDISCIPLINARY Nature reviews psychology Pub Date : 2024-01-24 DOI:10.1038/s44159-023-00269-7
Kathryn E. Lewandowski, Amy E. Pinkham, Tamsyn E. Van Rheenen
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摘要

社会认知障碍是精神分裂症谱系障碍的一个主要症状维度,在较小程度上也是双相情感障碍的一个主要症状维度,而且对不良的社区功能有很高的预测性。然而,目前还缺乏对社会认知领域(包括情绪处理、心智化、社会感知和/或知识以及归因风格)的细致描述,这妨碍了跨诊断比较,模糊了需要进一步研究和开发的领域,并限制了有针对性干预措施的开发。在本综述中,我们首先描述了精神分裂症-躁郁症谱系中各社会认知领域和疾病阶段的社会认知受损证据。接下来,我们将讨论特定社会认知领域(尤其是心智化和情绪处理)的障碍与社区功能受损和生活质量下降之间的联系。然后,我们将批判性地研究如何评估这些领域,以及现有的评估工具是否对精神分裂症谱系障碍和双相情感障碍中的社会认知障碍具有敏感性。最后,我们回顾了针对精神分裂症-双相情感障碍的社会认知的干预措施,并确定了需要进行系统评估和在临床实践中广泛实施的领域。基于这些信息,我们提出了一些建议,以加强对机制的了解和干预措施的开发,从而改善精神分裂症谱系障碍和双相情感障碍患者的社会认知能力和生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Social cognition across the schizophrenia–bipolar disorder spectrum
Impaired social cognition is a key symptom dimension in schizophrenia-spectrum disorders and — to a lesser extent — in bipolar disorder, and is highly predictive of poor community functioning. However, careful characterization of social cognitive domains (including emotion processing, mentalizing, social perception and/or knowledge, and attributional style) is lacking, which hampers transdiagnostic comparison, obscures areas requiring further research and development, and limits development of targeted interventions. In this Review, we first describe the evidence for impaired social cognition on the schizophrenia–bipolar spectrum across social cognitive domains and illness phases. Next, we discuss the links between impairments in specific social cognitive domains (particularly mentalizing and emotion processing) and impaired community functioning and reduced quality of life. We then critically examine how domains are assessed and whether available assessment batteries are sensitive to social cognitive impairments in schizophrenia-spectrum disorders and in bipolar disorder. Finally, we review interventions that target social cognition in schizophrenia–bipolar spectrum disorders and identify areas where systematic evaluation and widespread implementation into clinical practice are needed. Based on this information, we make recommendations for increased mechanistic understanding and intervention development to improve social cognition and quality of life for people diagnosed with schizophrenia-spectrum disorders and bipolar disorder. Impairments in social cognition are typical in schizophrenia–bipolar spectrum disorders. In this Review, Lewandowski and colleagues characterize impairments across social cognitive domains and illness phases including links with community functioning, and make recommendations for assessment and intervention.
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