Autistic trait severity in early schizophrenia: Role in subjective quality of life and social functioning

Cognitive impairment is a cardinal feature in patients with schizophrenia and leads to poor social functioning. Recently, the treatment of schizophrenia has evolved to include the goal of improving quality of life (QoL). However, most of the factors influencing subjective QoL are unknown. Autistic traits have been shown to co-occur with various psychiatric conditions including schizophrenia. Hence, the present study aimed to investigate whether cognitive function and autistic trait severity are associated with social functioning and subjective QoL in patients with early schizophrenia.

Data were analyzed from 183 outpatients diagnosed with early schizophrenia in Tokyo, Japan. Information was obtained on neurocognition with the Japanese version of the Brief Assessment of Cognition in Schizophrenia. Autistic trait severity was assessed using the Autism Spectrum Quotient (AQ), while social functioning was measured with the Specific Levels of Functioning Scale Japanese version. Information was obtained on subjective QoL with the Subjective Well-being under Neuroleptic drug treatment Short form, Japanese version. Multiple regression analysis was used to examined associations.

In an analysis adjusted for demographic characteristics (age, sex and education), both autistic trait severity (β = -0.56, p < 0.01) and neurocognitive function (β = 4.37, p < 0.01) were significantly associated with social function. On the other hand, only autistic trait severity made a significant contribution to the prediction of subjective QoL (β = -1.79, p < 0.01).

The results of this study suggest that efforts to detect and treat cognitive impairment and comorbid autistic trait in early schizophrenia may be important for improving social functioning and subjective QoL in this population. In particular intervention that targets autistic trait severity seems to be key to achieving personal recovery in patients with schizophrenia.