Email updates

Keep up to date with the latest news and content from BMC Psychiatry and BioMed Central.

Open Access Highly Accessed Open Badges Research article

The relationship between neurocognition and symptomatology in people with schizophrenia: social cognition as the mediator

Bess YH Lam1, Adrian Raine3* and Tatia MC Lee1245*

Author Affiliations

1 Laboratory of Neuropsychology, The Jockey Club Tower, The University of Hong Kong, Rm656, Pokfulam Road, Hong Kong, China

2 Laboratory of Cognitive Affective Neuroscience, The University of Hong Kong, Hong Kong, China

3 Departments of Criminology, Psychiatry, and Psychology, University of Pennsylvania, 3809 Walnut Street, Jerry Lee Centre of Criminology, Philadelphia, PA 19104, USA

4 The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China

5 Institute of Clinical Neuropsychology, The University of Hong Kong, Hong Kong, China

For all author emails, please log on.

BMC Psychiatry 2014, 14:138  doi:10.1186/1471-244X-14-138

Published: 13 May 2014



The relationship between neurocognition and symptomatology in people with schizophrenia has been established. The present study examined whether social cognition could mediate this relationship.


There were 119 participants (58 people with paranoid schizophrenia and 61 healthy controls) participated in this study. Neurocognition was assessed by Raven’s Progressive Matrices Test, the Judgment of Line Orientation Test, and the Tower of London Test. Psychiatric symptoms in people with schizophrenia were assessed by the Positive and Negative Syndrome Scale. Social cognition was measured by the Faux Pas Test, the “Reading the Mind in the Eyes” Test, and the Interpersonal Reactivity Index.


Results were consistent with previous findings that neurocognition and social cognition were impaired in the clinical participants. A novel observation is that social cognition significantly mediated the relationship between neurocognition and symptomatology.


These findings suggest that neurocognitive deficits predispose people with schizophrenia to worse psychiatric symptoms through the impairment of social cognition. Findings of the present study provide important insight into a functional model of schizophrenia that could guide the development of cost-effective interventions for people with schizophrenia.

Cognition; Faux pas; Eyes test; Theory of mind; Schizophrenia; Emotion