Psychiatric Quarterly

, Volume 87, Issue 3, pp 521–543 | Cite as

Oxytocin and Social Cognitions in Schizophrenia: A Systematic Review

  • Oksana Bukovskaya
  • Alexander Shmukler
Original Paper


Schizophrenia is a chronic multifactorial disorder. Over the last years, there has been a growing interest in cognitive deficits in schizophrenia, which is considered by many as the core abnormality of the disease. In the systematic review we focus on the social cognition and its correlation with the neuropeptide oxytocin, which is shown to be involved in the emotion recognizing processes, in the trust behavior and many other aspects of social functioning. The systematic review was performed in order to summarize the data on the liaison of oxytocin with the social cognition impairment in schizophrenia patients. Oxytocin is assumed to be a potential therapeutic agent for schizophrenia, with a special link to social cognitive functions. The oxytocinergic system is a promising neuromodulator of emotion recognition that may have the potential to normalize the social dysfunction seen in schizophrenia. Further studies are required to provide more data on the correlations between oxytocin and socialcognition as well as other schizophrenia symptoms.


Oxytocin Schizophrenia Cognition 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that the review was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors alone are responsible for the content and writing of the paper.


  1. 1.
    Abu-Akel A, Fischer-Shofty M, Levkovitz Y, Decety J, Shamay-Tsoory S: The role of oxytocin in empathy to the pain of conflictual out-group members among patients with schizophrenia. Psychological Medicine 44:3523–3532, 2014.CrossRefPubMedGoogle Scholar
  2. 2.
    Averbeck BB, Bobin T, Evans S, Shergill SS: Emotion recognition and oxytocin in patients with schizophrenia. Psychological Medicine 42: 259–266, 2012.CrossRefPubMedGoogle Scholar
  3. 3.
    Bakharev VD, Tikhomirov SM, Lozhkina TK: Psychotropic properties of oxytocin. Neuroscience and Behavioral Physiology 16:160–164, 1986.CrossRefPubMedGoogle Scholar
  4. 4.
    Barch DM, Keefe RSE: Anticipating DSM-V: Opportunities and challenges for cognition and psychosis. Schizophrenia Bulletin 36, 43–47, 2010.CrossRefPubMedGoogle Scholar
  5. 5.
    Barraza JA, Zak PJ: Empathy toward strangers triggers oxytocin release and subsequent generosity. Annals of the New York Academy of Sciences 1167:182–189, 2009.CrossRefPubMedGoogle Scholar
  6. 6.
    Bartz JA, Zaki J, Bolger N, Hollander E, Ludwig NN, Kolevzon A: Oxytocin selectively improves empathic accuracy. Psychological Science 21:1426–1428, 2010.CrossRefPubMedGoogle Scholar
  7. 7.
    Baumgartner T, Heinrichs M, Vonlanthen A, Fischbacher U, Fehr E: Oxytocin shapes the neural circuitry of trust and trust adaptation in humans. Neuron 58:639–650, 2008.CrossRefPubMedGoogle Scholar
  8. 8.
    Bujanow W: Hormones in the treatment of psychoses. British Medical Journal 4:298, 1972.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Bujanow W: Letter: Is oxytocin an anti-schizophrenic hormone? Canadian Psychiatric Association Journal 19:323, 1974.PubMedGoogle Scholar
  10. 10.
    Cacciotti-Saija C, Langdon R, Ward PB, Hickie IB, Scott EM, Naismith SL, Moore L, Alvares GA, Redoblado Hodge MA, Guastella AJ: A double-blind randomized controlled trial of oxytocin nasal spray and social cognition training for young people with early psychosis. Schizophrenia Bulletin 41:483–493, 2014.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Churchland PS, Winkielman P: Modulating social behavior with oxytocin: how does it work? What does it mean? Hormones and Behavior 61:392–399, 2012.CrossRefPubMedGoogle Scholar
  12. 12.
    Cochran DM, Fallon D, Hill M, Frazier JA: The role of oxytocin in psychiatric disorders: a review of biological and therapeutic research findings. Harvard Review of Psychiatry 21:219–247, 2013.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Pedersen CA, Chang SW, Williams CL: Editorial: Evolutionary perspectives on the role of oxytocin in human social behavior, social cognition and psychopathology. Brain Research 1580:1–7, 2013.CrossRefGoogle Scholar
  14. 14.
    Davis MC, Green MF, Lee J, Horan WP, Senturk D, Clarke AD, Marder SR: Oxytocin-augmented social cognitive skills training in schizophrenia. Neuropsychopharmacology 39:2070–2077, 2014.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Davis MC, Lee J, Horan WP, Clarke AD, McGee MR, Green MF, Marder SR: Effects of single dose intranasal oxytocin on social cognition in schizophrenia. Schizophrenia Research 147:393–397, 2013.CrossRefPubMedGoogle Scholar
  16. 16.
    De Dreu CK, Greer LL, Handgraaf MJ, Shalvi S, Van Kleef GA, Baas M: The neuropeptide oxytocin regulates parochial altruism in intergroup conflict among humans. Science 328:1408—1411,2010.CrossRefPubMedGoogle Scholar
  17. 17.
    De Dreu CK, Greer LL, Van Kleef GA, Shalvi S, Handgraaf MJ: Oxytocin promotes human ethnocentrism. Proceedings of the National Academy of Sciences 108:1262–1266, 2011.CrossRefGoogle Scholar
  18. 18.
    American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th edn. American Psychiatric Association, Washington, DC, 2013.Google Scholar
  19. 19.
    Domes G, Heinrichs M, Glascher J, Buchel C, Braus DF, Herpertz SC: Oxytocin attenuates amygdala responses to emotional faces regardless of valence. Biological Psychiatry 62:1187–1190, 2007.CrossRefPubMedGoogle Scholar
  20. 20.
    Domes G, Sibold M, Schulze L, Lischke A, Herpertz SC, Heinrichs M: Intranasal oxytocin increases covert attention to positive social cues. Psychological Medicine 43:1747–1753, 2013.CrossRefPubMedGoogle Scholar
  21. 21.
    Domes G, Heinrichs M, Michel A, Berger C, Herpertz SC: Oxytocin improves ‘‘mind-reading’’ in humans. Biological Psychiatry 61: 731–733, 2007.CrossRefPubMedGoogle Scholar
  22. 22.
    Brown EC, Tas C, Kuzu D, Esen-Danaci A, Roelofs K, Brüne M: Social approach and avoidance behaviour for negative emotions is modulated by endogenous oxytocin and paranoia in schizophrenia. Psychiatry Research 219:436–442, 2014.CrossRefPubMedGoogle Scholar
  23. 23.
    Engell AD, Haxby JV, Todorov A: Implicit trustworthiness decisions: automatic coding of face properties in the human amygdala. Journal of Cognitive Neuroscience 19: 1508–1519, 2007.CrossRefPubMedGoogle Scholar
  24. 24.
    Feifel D, Macdonald K, Nguyen A, Cobb P, Warlan H, Galangue B: Adjunctive intranasal oxytocin reduces symptoms in schizophrenia patients. Biological Psychiatry 68:678–680, 2010.CrossRefPubMedGoogle Scholar
  25. 25.
    Fischer-Shofty M, Shamay-Tsoory SG, Harari H, Levkovitz Y: The effect of intranasal administration of oxytocin on fear recognition. Neuropsychologia 48:179–184, 2010.CrossRefPubMedGoogle Scholar
  26. 26.
    Fischer-Shofty M, Shamay-Tsoory SG, Levkovitz Y: Characterization of the effects of oxytocin on fear recognition in patients with schizophrenia and in healthy controls. Frontiers in Neuroscience 7:127, 2013.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Gibson CM, Penn DL, Smedley KL, Leserman J, Elliott T, Pedersen CA: A pilot six-week randomized controlled trial of oxytocin on social cognition and social skills in schizophrenia. Schizophrenia Research 156:261–265, 2014.CrossRefPubMedGoogle Scholar
  28. 28.
    Goldman M, Marlow-O’Connor M, Torres I, Carter CS: Diminished plasma oxytocin in schizophrenic patients with neuroendocrine dysfunction and emotional deficits. Schizophrenia Research 98:247–255, 2008.CrossRefPubMedGoogle Scholar
  29. 29.
    Goldman M, Gomes AM, Carter CS, Lee R: Divergent effects of two different doses of intranasal oxytocin on facial affect discrimination in schizophrenic patients with and without polydipsia. Psychopharmacology (Berl) 216: 101–110, 2011.CrossRefGoogle Scholar
  30. 30.
    Guastella AJ, Mitchell PB, Dadds MR: Oxytocin increases gaze to the eye region of human faces. Biological Psychiatry 63:3–5, 2008.CrossRefPubMedGoogle Scholar
  31. 31.
    Guastella AJ, MacLoed C: A critical review of the influence of oxytocin nasal spray on social cognition in humans: Evidence and future directions. Hormones and Behavior 61:410–418, 2012.CrossRefPubMedGoogle Scholar
  32. 32.
    Heinrichs M, Baumgartner T, Kirschbaum C, Ehlert U: Social support and oxytocin interact to suppress cortisol and subjective responses to psychological stress. Biological Psychiatry 54:1389–1398, 2003.CrossRefPubMedGoogle Scholar
  33. 33.
    Jackson PL, Meltzoff AN, Decety J: How do we perceive the pain of others? A window into the neural processes involved in empathy. NeuroImage 24:771–779, 2005.CrossRefPubMedGoogle Scholar
  34. 34.
    Keri S, Kiss I, Kelemen O: Sharing secrets: Oxytocin and trust in schizophrenia. Social Neuroscience 4:287–293, 2009.CrossRefPubMedGoogle Scholar
  35. 35.
    Kirsch P, Esslinger C, Chen Q, Mier D, Lis S, Siddhanti S: Oxytocin modulates neural circuitry for social cognition and fear in humans. Journal of Neuroscience 25:11489–11493, 2005.CrossRefPubMedGoogle Scholar
  36. 36.
    Kiss A, Mikkelsen JD: Oxytocin–anatomy and functional assignments: A minireview. Endocrine Regulations 39:97–105, 2005.Google Scholar
  37. 37.
    Koscik TR, Tranel D: The human amygdala is necessary for developing and expressing normal interpersonal trust. Neuropsychologia 49:602–611, 2011.CrossRefPubMedGoogle Scholar
  38. 38.
    Kosfeld M, Heinrichs M, Zak PJ, Fischbacher U, Fehr E: Oxytocin increases trust in humans. Nature 435:673–676, 2005.CrossRefPubMedGoogle Scholar
  39. 39.
    Krueger F, Parasuraman R, Moody L, Twieg P, de Visser E, McCabe K, O’Hara M, Lee MR: Oxytocin selectively increases perceptions of harm for victims but not the desire to punish offenders of criminal offenses. Social Cognitive and Affective Neuroscience 8:494–498, 2013.CrossRefPubMedGoogle Scholar
  40. 40.
    Liedman R, Hansson SR, Howe D, Igidbashian S, McLeod A, Russell RJ, Akerlund M: Reproductive hormones in plasma over the menstrual cycle in primary dysmenorrhea compared with healthy subjects. Gynecological Endocrinology 24:508–513, 2008.CrossRefPubMedGoogle Scholar
  41. 41.
    Lischke A, Berger C, Prehn K, Heinrichs M, Herpertz SC, Domes G: Intranasal oxytocin enhances emotion recognition from dynamic facial expressions and leaves eye-gaze unaffected. Psychoneuroendocrinology 37:475–481, 2012.CrossRefPubMedGoogle Scholar
  42. 42.
    Lischke A, Gamer M, Berger C, Grossmann A, Hauenstein K, Heinrichs M, Herpertz SC, Domes G: Oxytocin increases amygdala reactivity to threatening scenes in females. Psychoneuroendocrinology 37:1431–1438, 2012.CrossRefPubMedGoogle Scholar
  43. 43.
    MacDonald K, Feifel D: Oxytocin in schizophrenia: A review of evidence for its therapeutic effects. Acta Neuropsychiatrica 24:130–146, 2012.CrossRefPubMedGoogle Scholar
  44. 44.
    MacEwan TH, Athawes RWB: The Nithsdale Shizophrenia surveys XV. Social adjustment in schizophrenia associations with gender, symptoms and childhood antecedents. Acta Psychiatrica Scandinavica 95:254–258, 1997.CrossRefGoogle Scholar
  45. 45.
    Marsh AA, Yu HH, Pine DS, Blair RJ: Oxytocin improves specific recognition of positive facial expressions. Psychopharmacology (Berl) 209:225–232, 2010.CrossRefGoogle Scholar
  46. 46.
    Meyer-Lindenberg A, Domes G, Kirsch P, Heinrichs M: Oxytocin and vasopressin in the human brain: Social neuropeptides for translational medicine. Nature Reviews Neuroscience 12:524–538, 2011.CrossRefPubMedGoogle Scholar
  47. 47.
    Millan MJ, Fone K, Steckler T, Horan WP: Negative symptoms of schizophrenia: Clinical characteristics, pathophysiological substrates, experimental models and prospects for improved treatment. European Neuropsychopharmacology 24:645–692, 2014.CrossRefPubMedGoogle Scholar
  48. 48.
    Millan MJ, Bales KL: Towards improved animal models for evaluating social cognition and its disruption in schizophrenia: The CNTRICS initiative. Neuroscience and Biobehavioral Reviews 37:2166–2180, 2013.CrossRefPubMedGoogle Scholar
  49. 49.
    Mohamed S, Paulsen JS, O’Leary D, Arndt S, Andreasen N: Generalized cognitive deficits in schizophrenia: A study of first-episode patients. Archives of General Psychiatry 56:749–754, 1999.CrossRefPubMedGoogle Scholar
  50. 50.
    Pedersen CA, Gibson CM, Rau SW, Salimi K, Smedley KL, Casey RL, Leserman J, Jarskog LF, Penn DL: Intranasal oxytocin reduces psychotic symptoms and improves theory of mind and social perception in schizophrenia. Schizophrenia Research 132:50–53, 2011.CrossRefPubMedGoogle Scholar
  51. 51.
    Pedersen CA, Rau S, Salimi K, Gibson C, Leserman J, Penn D: Oxytocin treatment improves social cognition and reduces psychotic symptoms in schizophrenia (poster); Paper presented at the American College of Neuropsychopharmacology.Google Scholar
  52. 52.
    Penn DL, Sanna LJ, Roberts DL: Social cognition in schizophrenia: An overview. Schizophrenia Bulletin 34:408–411, 2008.CrossRefPubMedPubMedCentralGoogle Scholar
  53. 53.
    Perez-Rodriguez MM, Mahon K, Russo M, Ungar AK, Burdick KE: Oxytocin and social cognition in affective and psychotic disorders. European Neuropsychopharmacology 25:265–282, 2015.Google Scholar
  54. 54.
    Reichenberg A, Harvey PD: Neuropsychological impairments in schizophrenia: Integration of performance-based and brain imaging findings. Psychological Bulletin 133:833–858.CrossRefPubMedGoogle Scholar
  55. 55.
    Rosenfeld AJ, Lieberman JA, Jarskog LF: Oxytocin, dopamine, and the amygdala: A neurofunctional model of social cognitive deficits in schizophrenia. Schizophrenia Bulletin 37:1077–1087, 2011.CrossRefPubMedGoogle Scholar
  56. 56.
    Rubin LH, Carter CS, Drogos L, Jamadar R, Pournajafi-Nazarloo H, Sweeney JA: Sex-specific associations between peripheral oxytocin and emotion perception in schizophrenia. Schizophrenia Research 130:266–270, 2011.CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Rubin LH, Carter CS, Drogos L, Pournajafi-Nazarloo H, Sweeney JA, Maki PM: Peripheral oxytocin is associated with reduced symptom severity in schizophrenia. Schizophrenia Research 124:13–21, 2010.CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    Schulze L, Lischke A, Greif J, Herpertz SC, Heinrichs M, Domes G: Oxytocin increases recognition of masked emotional faces. Psychoneuroendocrinology 36:1378–1382, 2011.CrossRefPubMedGoogle Scholar
  59. 59.
    Shahrestani S, Kemp AH, Guastella AJ: The impact of a single administration of intranasal oxytocin on the recognition of basic emotions in humans: A meta-analysis. Neuropsychopharmacology 38: 1929–1936, 2013.CrossRefPubMedPubMedCentralGoogle Scholar
  60. 60.
    Stallen M, De Dreu CK, Shalvi S, Smidts A, Sanfey AG: The herding hormone: Oxytocin stimulates in-group conformity. Psychological Science 23:1288–1292, 2012.CrossRefPubMedGoogle Scholar
  61. 61.
    Theodoridou A, Rowe AC, Penton-Voak IS, Rogers PJ: Oxytocin and social perception: Oxytocin increases perceived facial trustworthiness and attractiveness. Hormones and Behavior 56:128–132, 2009.CrossRefPubMedGoogle Scholar
  62. 62.
    Tops M, van Peer JM, Korf J, Wijers AA, Tucker DM: Anxiety, cortisol, and attachment predict plasma oxytocin. Psychophysiology 44:444–449, 2007.CrossRefPubMedGoogle Scholar
  63. 63.
    Van IJzendoorn MH, Bakermans-Kranenburg MJ: A sniff of trust: Meta-analysis of the effects of intranasal oxytocin administration on face recognition, trust to in-group, and trust to out-group. Psychoneuroendocrinology 37:438–443, 2012.Google Scholar
  64. 64.
    Walss-Bass C, Fernandes JM, Roberts DL, Service H, Velligan D: Differential correlations between plasma oxytocin and social cognitive capacity and bias in schizophrenia. Schizophrenia Research 147:387–392, 2013.CrossRefGoogle Scholar
  65. 65.
    Wittchen HU, Jacobi F, Rehm J, Gustavsson A, Svensson M, Jonsson B,Olesen J, Allgulander C, Alonso J, Faravelli C, Fratiglioni L, Jennum P, Lieb R, Maercker A, Van Os J, Preisig M, Salvador-Carulla L, Simon R, Steinhausen HC: The size and burden of mental disorders and other disorders of the brain in Europe. European Neuropsychopharmacology 21:655–679.CrossRefPubMedGoogle Scholar
  66. 66.
    Woolley JD, Chuang B, Lam O, Lai W, O’Donovan A, Rankin KP, Mathalon DH, Vinogradov S: Oxytocin administration enhances controlled social cognition in patients with schizophrenia. Psychoneuroendocrinology 47:116–125, 2014.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Moscow Research Institute of Psychiatry - The Branch of the Federal State Budgetary Institution “Federal Medical Research Centre for Psychiatry and Narcology” of the Ministry of Health of the Russian FederationMoscowRussia

Personalised recommendations