Exploration de la cognition sociale dans la schizophrénie : apports de l'analyse groupale et individuelle

Abstract

Background The deficit in social cognition in schizophrenia has been demonstrated in numerous studies and metaanalyses. However, previous studies have focused on a group evaluation of social cognition, without exploring interindividual and intergroup variations on populations of different cultures. In addition, the international literature is focused on data from industrialized countries. In Africa, and particularly in the Democratic Republic of Congo, there are no data. Methods We conducted case-control studies of 60 and 58 subjects respectively in the Democratic Republic of Congo and Belgium to determine the variability of performance in social cognition evaluated by the ClaCos, in its various components, between subjects of different cultures (patients and healthy controls Belgians and Congolese) and within the Belgian and Congolese groups. The ClaCos explores the areas of social cognition described by Green et al., 2008 : the TREF (facial emotion recognition test) for emotional perception, PerSo for social Perception and social Knowledge, MASC (Movie for the Assessment of Social Cognition) for Theory of Mind and AIHQ for Attribution Style. This battery also allows the evaluation of empathy performance by the QCAE and subjective abilities in social cognition by the ACSO. Results The results of the recognition of emotions among schizophrenic patients in the Democratic Republic of Congo (DRC) (GMB Kitoko et al., 2019) and the social perception and social knowledge of schizophrenic patients in Belgium (GMB Kitoko et al., 2020) have been published in the form of V articles in scientific journals. Overall, patients with schizophrenia showed impaired and heterogeneous performance in all social cognition assessment tasks, within each group and between groups in two countries. Social cognitive abilities were partially independent from patients' neurocognitive abilities, and clinical symptoms. In both groups, patients showed deficits in facial emotion recognition. These results confirmed the intercultural generalization of emotional facial recognition deficits in patients with schizophrenia. In the Belgium group, patients also showed deficits in social perception and social knowledge, attributional style and Theory of Mind. Finally, the profile of the results on the different ClaCoS battery tests was similar in both groups. The differences between patients and controls were more significant in Belgium than in the Democratic Republic of Congo. Conclusion Patients with schizophrenia have group and specific social cognition deficits generalized to patients of different cultures. The heterogeneity of deficits is observed within the group and between patients in two countries. These deficits are partially independent of neurocognition and clinical characteristics. They are an essential component of schizophrenia. However, the Clacos battery has shown little sensitivity in the Congolese population. Exploration and management of cognition deficits should be integrated into therapeutic programs for patients with schizophrenia. It is also essential to develop tools for assessing social cognition adapted to the African cultural context.(MED - Sciences médicales) -- UCL, 202