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Subjective experience of social cognition in adolescents at ultra-high risk of psychosis: findings from a 24-month follow-up study

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Deficits in social cognition have been reported in people at ultra-high risk (UHR) of psychosis exclusively using socio-cognitive tasks and in adolescent and young adult mixed population. Aim of this study was (1) to assess subjective experience of social cognition in adolescent help-seekers identified through UHR criteria, (2) to explore its significant correlations with psychopathology and functioning in UHR individuals; and (3) to monitor longitudinally its stability after a 24-month follow-up period. Participants [51 UHR, 91 first-episode psychosis (FEP), and 48 non-UHR/FEP patients], aged 13–18 years, completed the comprehensive assessment of at-risk mental states and the GEOPTE scale of social cognition for psychosis. In comparison with non-UHR/FEP patients, both UHR and FEP adolescents showed significantly higher GEOPTE total scores. After 12 months of follow-up, UHR individuals had a significant decrease in severity on GEOPTE “Social Cognition” subscore. In the UHR group at baseline, GEOPTE scores had significant positive correlations with general psychopathology, positive and negative dimensions. Across the 2-year follow-up period, social cognition subscores specifically showed more stable associations with general psychopathology and negative symptoms. Social cognition deficits are prominent in UHR adolescents and similar in severity to those of FEP patients at baseline. However, these impairments decreased over time, presumably together with delivery of targeted, specialized models for early intervention in psychosis.

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This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. ReARMS project is partly financed through a special, treatment-oriented regional fund: “Progetto Esordi Psicotici della Regione Emilia Romagna”. The ReARMS technical-scientific multi-professional steering committee was established in 2012 and included in alphabetical order: Azzali Silvia (psychologist), Cioncolini Leonardo (head nurse), Chiri Luigi Rocco (psychologist), Fabiani Michela (child-adolescent psychiatrist), Favazzo Rosanna (psychiatrist), Fontana Francesca (psychiatrist), Garlassi Sara (psychologist), Paterlini Federica (psychologist), Pelizza Lorenzo (psychiatrist), Pensieri Luana (child-adolescent psychologist), Raballo Andrea (psychiatrist), Scazza Ilaria (psychologist), and Semrov Enrico (senior psychiatrist). We wish to thank all the patients and family members who actively participated to the ReARMS program, and we gratefully acknowledge the facilitating support of Dr. Enrico Semrov and all the other colleagues of the Reggio Emilia Department of Mental Health and Pathological Addiction for their technical and administrative support. Further to that, we wish to thank Dr. Eva Gebhardt who acted as external advisor insuring wide-spread educational training and clinical-supervision support.


This research did not receive any specific grant from funding agency, commercial or not-for-profit sector. ReARMS project is partly financed through a special regional fund: “Progetto Esordi Psicotici della Regione Emilia Romagna”.

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Correspondence to Lorenzo Pelizza.

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All the participants and their parents (if minors) agreed to participate to the research and gave their informed consent to the psychopathological assessment prior to their inclusion in the research. Relevant local ethical approvals were sought for the study. The current research has been carried-out in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki) for experimental protocols including humans.

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Pelizza, L., Poletti, M., Azzali, S. et al. Subjective experience of social cognition in adolescents at ultra-high risk of psychosis: findings from a 24-month follow-up study. Eur Child Adolesc Psychiatry (2020). https://doi.org/10.1007/s00787-020-01482-y

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  • Social cognition
  • Emotion recognition
  • Ultra-high risk
  • Psychosis
  • Prodrome