Article Dans Une Revue Comprehensive Psychiatry Année : 2025

Flowers for Algernon: How Metacognition Affects Quality of Life in Schizophrenia. Structural Equation Modeling with the Face-Sz Cohort

1 CHV - Centre Hospitalier de Versailles André Mignot
2 CESP - Centre de recherche en épidémiologie et santé des populations
3 Fondation FondaMental [Créteil]
4 LPNC - Laboratoire de Psychologie et NeuroCognition
5 Institut de Psychotraumatisme de l’Enfant et de l’Adolescent [Versailles, France]
6 CESP - Centre de recherche en épidémiologie et santé des populations
7 INSERM - Institut National de la Santé et de la Recherche Médicale
8 Université Paris-Saclay
9 AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
10 CNRS - Centre National de la Recherche Scientifique
11 HUS - Hôpitaux Universitaires de Strasbourg
12 NCPS - Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie
13 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
14 Hôpital la Colombière [CHU Montpellier]
15 C3M - Centre méditerranéen de médecine moléculaire
16 IGF - Institut de Génomique Fonctionnelle
17 SAGE - Sociétés, Acteurs, Gouvernement en Europe
18 CRNL - Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
19 Centre Hospitalier le Vinatier [Bron]
20 Hôpital Louis Mourier - AP-HP [Colombes]
21 IPNP - U1266 Inserm - Institut de psychiatrie et neurosciences de Paris
22 GIN - [GIN] Grenoble Institut des Neurosciences
23 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
24 TIMONE - Hôpital de la Timone [CHU - APHM]
25 CEReSS - Centre d'études et de recherche sur les services de santé et la qualité de vie
26 IP - Institut Pascal
27 CHU Clermont-Ferrand
28 AFPBN - Association française de psychiatrie biologique et neuropsychopharmacologie = French Society for Biological Psychiatry and Neuropsychopharmacology
29 INCIA - Institut de Neurosciences cognitives et intégratives d'Aquitaine
30 Centre hospitalier Charles Perrens [Bordeaux]
31 IMRB - Institut Mondor de Recherche Biomédicale
32 Hôpital Henri Mondor
33 U955 Inserm - UPEC - IMRB - "Neuropsychiatrie translationnelle" [Créteil]
34 Pôle de Psychiatrie [Hôpital Henri Mondor]
35 CEISAM - Chimie Et Interdisciplinarité : Synthèse, Analyse, Modélisation

Résumé

Background and HypothesisWe examined the association between metacognitive performance, functioning, and quality of life (QoL) in schizophrenia using structural equation model analyses.Study DesignA sample of 249 participants was assessed for symptoms, functioning, QoL, and both objective and subjective cognitive performance. Metacognitive performance was defined as the adequation between objective and subjective measures of cognitive performance.Study ResultsOur model showed an excellent fit (CFI = 0.981; RMSEA = 0.014–0.081) and explained 53.3% of the variance in functioning and 50.3% in QoL. Metacognitive performance was not significantly associated with functioning but showed a negative association with QoL (β = -0.383, p < 0.001). Thus, a greater underestimation of one’s cognitive abilities was linked with lower QoL, potentially reflecting heightened awareness of deficits that affect well-being. Depression, also negatively associated with QoL (β = -0.359, p < 0.001), was linked to the underestimation of cognitive abilities, whereas symptom severity was associated with their overestimation (β = -0.296, p < 0.001). Complementary analyses suggest that the subjective cognition model closely mirrors that of metacognitive performance, questioning the distinctiveness of metacognition as an explanatory factor in schizophrenia outcomes.Conclusion Our findings imply that interventions that boost confidence in cognitive abilities, such as cognitive remediation, may improve QoL. Future research should investigate the causal pathways between these factors and explore the role of social cognition, often impaired in schizophrenia, as another mediator. Comprehensive treatment that addresses clinical symptoms, depression, and subjective cognition challenges appear essential to improve outcomes in schizophrenia.

Fichier principal
Vignette du fichier
ssrn-5182240.pdf (1.63 Mo) Télécharger le fichier
Origine Fichiers produits par l'(les) auteur(s)
Licence

Dates et versions

hal-05001738 , version 1 (22-03-2025)

Licence

Identifiants

Citer

Solène Frileux, Nathan Faivre, Mathieu Urbach, Nathan Vidal, Hugo Bottemanne, et al.. Flowers for Algernon: How Metacognition Affects Quality of Life in Schizophrenia. Structural Equation Modeling with the Face-Sz Cohort. Comprehensive Psychiatry, 2025, 142, pp.152622. ⟨10.1016/j.comppsych.2025.152622⟩. ⟨hal-05001738⟩
4780 Consultations
425 Téléchargements

Altmetric

Partager

  • More