The Influence of Premorbid Adjustment and Autistic Traits on Social Cognitive Dysfunction in Schizophrenia

Margherita Bechi, Giulia Agostoni, Mariachiara Buonocore, Francesca Bosinelli, Marco Spangaro, Laura Bianchi, Federica Cocchi, Carmelo Guglielmino, Roberto Cavallaro, Marta Bosia

Research output: Contribution to journalArticlepeer-review


Objectives: Premorbid dysfunction during childhood and adolescence is well documented in patients with schizophrenia. Literature pointed out multiple premorbid trajectories leading to different patients' cognitive status, symptomatology, and global functioning after disease onset. This study aimed at identifying groups of premorbid trajectories and disentangling between group differences in clinical and cognitive measures, focusing on theory of mind (ToM) and autistic traits (ATs).Methods: Ninety-seven patients with schizophrenia were recruited and assessed for cognitive and ToM abilities, psychopathology, and ATs. A two-step cluster analysis identified three different groups of patients based on premorbid adjustment during childhood, adolescence, and late adolescence (i.e., stable-good, stable-poor, and deteriorating).Results: Compared to 66 healthy controls, results showed a widespread impairment in cognitive and ToM abilities among all groups of patients, except for affective ToM and executive functions in the stable-good group. Moreover, the stable-poor group exhibited more pronounced ATs and a more severe ToM impairment, compared to the other two groups of patients.Conclusions: Our findings highlight the existence of a group of patients with poor premorbid adjustment since childhood, more pronounced ATs and a severe ToM impairment affecting those basic mentalizing skills that are usually preserved in schizophrenia. Results might have intriguing implications in identifying underpinning endophenotypes and implementing cutting-edge rehabilitation programs.

Original languageEnglish
Pages (from-to)276-285
Number of pages10
JournalJournal of the International Neuropsychological Society
Issue number3
Publication statusPublished - Mar 1 2020


  • Autism spectrum disorder
  • Cognition
  • Neurodevelopmental disorders
  • Premorbid functioning
  • Psychosis
  • Theory of mind

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Psychology
  • Clinical Neurology
  • Psychiatry and Mental health


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