The role of metacognition and social cognition in childhood trauma effecting on prognosis: 1-year follow-up study in patients with first-episode schizophrenia.

Background: Childhood trauma (CT) is common in first episode schizophrenia (FES), affecting prognosis and functionality. However, the mechanisms by which CT effects prognosis are not clear. This study aimed to investigate how metacognition (MC) and social cognition (SC) mediate effects of CT on symptoms in FEP.

Methods: 52 first episode schizophrenia patients who were diagnosed for first time and had been symptomatic for at most 2 years were included. Patients were administered Metacognition Assessment Scale-Abbreviated to assess MC; Reading the Mind in the Eyes Test, Facial Emotion Recognition and Discrimination Tests to assess SC; Positive and Negative Syndrome Scale to assess psychopathology and Global Assessment of Functioning Scale to assess functionality at first interview. Patients were followed up for 1 year. At second interview the above scales and Childhood Trauma Questionnaire-33 were applied to 38 patients who met remission criteria.

Results: MC and SC modulated effects of CT on negative symptoms, but not on positive symptoms. CT had different effects on symptoms, MC and SC skills in episode and remission. Pharmacological treatment was not sufficient to improve these skills.

Conclusions: MC and SC skills are important in modulating CT effecting on prognosis and non-pharmacological interventions should be developed to improve these skills.

Clinical trial number: Not applicable.