Social outcomes in schizophrenia: from description to action

The reality of schizophrenia is not fully expressed by measures of psychopathology and both descriptive research and research into interventions benefit from the investigation of social outcomes. We define these as measures which reflect performance compared to normal social expectations, either of oneself or of another. The studies we reviewed looked at the effects on summary measures, for example, quality of life, as well as simpler, more self-explanatory outcomes such as employment, marital status, financial independence and housing.

The review contrasts studies which describe the determinants of social outcomes and studies designed to estimate the effects of interventions on these outcomes. Recent descriptive studies demonstrate that social outcomes have both longitudinal and cross-sectional associations with cognitive impairment, preexisting functional impairment and certain symptoms. Studies of both pharmacological and social interventions suggest that, at best, these can affect social outcomes.

Simpler social outcomes are reported less frequently than summary measures which can make interpretation more difficult, thus diluting a potential advantage of social outcome measures to researchers and clinicians alike. Social outcomes are underreported compared to measures of psychopathology, particularly in trials of interventions.