Association of empathy with clinical symptoms and cognitive function in Chinese chronic schizophrenia patients with and without deficit syndrome

Background: Patients with deficit syndrome (DS) are known to experience cognitive impairment. However, there is no consistent conclusion on the impairment of neurocognitive features in DS patients, and no studies have examined their empathy. The purpose of this study was to compare neurocognition and empathy in patients with DS and non-DS schizophrenia. Methods: Totally, 665 patients with chronic schizophrenia were enrolled. DS patients were identified by the Proxy Scale for Deficit Syndrome (PDS). Neurocognition and social cognition were assessed by Repeatable Battery for the measurement of Neuropsychological Status (RBANS) and the Interpersonal Reactivity Index (IRI), respectively. In addition, psychopathological symptom severity was assessed by the Positive and Negative Syndrome Scale (PANSS). Results: Participants included 150 patients with DS and 140 patients with non-DS. DS patients performed significantly worse on the all RBANS domain (except for visuospatial) and total scores as well as IRI scores. Regression analysis showed that PANSS general psychopathology and education were associated with RBANS total score in the DS group (adjusted R-2 = 0.29), while education and PANSS negative symptoms were correlated with RBANS total score in non-DS patients (adjusted R-2 = 0.33). In the non-DS group, suicide attempts and PANSS negative symptom score were independently associated with IRI total score (adjusted R-2 = 0.06), whereas in the DS group, no variable was associated with IRI total score. Conclusions: Our findings suggest that patients with DS may have poor neumcognitive and empathy performance. In chronic schizophrenia patients, negative symptoms may play a different role in cognition between DS and non-DS groups.