Şizofrenide öne çıkan yeni bir boyut: Sosyal biliş

Amaç: Kişinin sosyal çevresi ile ilişkisini şekillendiren sosyal biliş, şizofreni çalışmalarında hızla gelişen bir alan haline gelmektedir. Bu çalışmada, şizofreni alanı içinde sosyal bilişin tanımlanması, sosyal bilişin klinik değişkenler ve psikososyal işlevsellikle olan ilişkisinin ortaya konması ve çeşitli tedavilerin sosyal biliş üzerindeki etkisinin tartışılması amaçlanmaktadır. Yöntem: PsycINFO ve MEDLINE/PUBMED veritabanlarındaki şizofreni alanında sosyal biliş ile ilgili yapılan çalışmaların verileri gözden geçirilmiştir. Bulgular: Şizofrenide sosyal biliş; duygu algılama, sosyal bilgi, sosyal algı, atıfsal yanlılık ve zihin kuramı alanlarında incelenmektedir. Şizofreni hastaları pozitif ve negatif belirtiler ve özellikle de negatif belirtilerin şiddeti ile ilişkili olan ciddi sosyal biliş bozulmaları yaşamaktadırlar. Nörobilişsel işlevlerden bağımsız olan sosyal biliş, nörobilişsel işlevler ve işlevsellik arasında aracı bir görev üstlenmektedir. İşlevsellikle olan yoğun ilişkisi nedeniyle, sosyal biliş şizofrenide önemli bir tedavi hedefidir. Bu amaçla geliştirilen tedavi yöntemleri ile sosyal bilişsel işlevlerde ve psikososyal işlevsellikte belirli bir iyileşme sağlanmaktadır. Bu nedenle, sosyal bilişsel müdahaleler şizofreni tedavisinde umut vaad eden bir alandır. Sonuç: Sosyal biliş bozulmaları, şizofrenide psikososyal işlevselliği yordayan önemli bir etken olarak dikkati çekmektedir. Bu nedenle, hastaların hayatlarını ve işlevselliklerini etkileyen şizofreni hastalığı için sosyal bilişi geliştirme müdahaleleri, şizofreninin iyileşmesinde önemli bir basamak olabilir.

A new featured dimension in schizophrenia: Social cognition

Objective: Social cognition which shapes the relationship of the individual with his/her social environment is a developing field in the study of schizophrenia. This study aims at establishing the definition of the social cognition, specifying the relationship between the social cognition and the clinical variables and also psychosocial functioning, discussing the effects of various treatment methods on the social cognition. Method: The studies about the social cognition found in the PsycINFO and MEDLINE/PUBMED databases have been overviewed. Results: Social cognition is examined through the fields of emotional perception, social knowledge, social perception, attributional bias and the theory of mind. Patients with schizophrenia suffer from serious social cognitive impairments which are related to positive/negative symptoms and especially to the intensity of the negative symptoms. Social cognition, though independent from neurocognition, acts as a mediator between neurocognition and the functioning. Due to its relation to the functioning, social cognition is an important target of treatment in schizophrenia. The developed treatment approaches provide some improvement in social cognitive functions and psychosocial functioning. Therefore, social cognitive interventions become a promising field in the treatment of schizophrenia. Conclusion: The social cognitive impairments attract attention as the most important factor predicting psychosocial functioning in schizophrenia. That is the reason why the interventions on improving social cognition in schizophrenia which affects patients lives and functionings might be a considerable step to cure schizophrenia.

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