Social cognition is considered as a main predictor of functional outcomes and a candidate for endophenotype of schizophrenia. We hypothesize that social cognition capacities follow the course of schizophrenia as a progredient disorder.

To investigate social cognition across different groups of patients with schizophrenia and schizophrenia spectrum disorders.

To evaluate social cognitive impairments in patients with first episode psychoses (FEP), chronic schizophrenia (CS) and schizophrenia-spectrum disorders (SSD).

In a cross-sectional study, 71 patients with FEP, CS and SSD were assessed with a battery of clinical and social cognitive tests. Three key social cognitive domains were assessed: emotion perception, Theory of Mind and attributional style.

Patients with schizoaffective disorder and schizotypal disorder showed better scores in Hinting task (mean ranks: 47.0 and 39.9 respectively) than patients with less favourable forms of schizophrenia (mean ranks: 24.7 and 30.2 respectively) (P = 0.003). Patients with FEP showed better results in Hinting task (18.1 ± 2.4) versus CS patients (17.4 ± 2.0) (P < 0.05). No differences in emotion perception (Ekman-60 task) among FEP and CS patients were detected. Patients with schizoaffective disorder showed better scores in emotional processing comparing to all forms of schizophrenia patients (mean ranks 49.1 vs. 30.1, 34.5, 28.0, P < 0.05). No significant differences in attributional style were registered.

Emotion perception and Theory of Mind domains show different level of impairment across FEP and CS patients and across forms of schizophrenia. Further longitudinal studies to establish how social cognition domains mirror the course and severity of schizophrenia and SSD are needed.

The authors have not supplied their declaration of competing interest.