***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE The relationship between cognition and outcome in people with schizophrenia has been established in studies that , for the most part , examined chronic patients and were cross-sectional in design . The purpose of this study was to analyze the relationships between neurocognitive variables assessed at illness onset and functional outcome in a longitudinal design . An additional area of interest was whether the severity of negative symptoms would predict outcome independently from neurocognitive variables or whether there would be an overlap in their predictive power . METHOD The authors administered a comprehensive cognitive battery and clinical assessment s to 99 subjects who were in their first episode of illness and analyzed the relationship of cognition and symptom severity at intake with community outcome after an average follow-up period of 7 years . RESULTS Verbal memory , processing speed and attention , and the severity of negative symptoms at intake were related to subsequent outcome . Global psychosocial functioning was predicted by negative symptoms and attention . Verbal memory was the significant predictor of the degree of impairment in recreational activities . Impairment in relationships was predicted by negative symptoms and memory , whereas attention and negative symptoms were predictive of work performance . There was an overlap in the variance in outcome explained by cognitive variables and negative symptoms . CONCLUSIONS Verbal memory and processing speed and attention are potential targets for psychosocial interventions to improve outcome . Results from cross-sectional or chronic patient studies do not necessarily correspond to the findings of this prospect i ve first-episode study in which cognition appears to explain less of the variance in outcome Neurocognitive deficits are believed to be important predictors of functional outcome in chronic psychotic disorders , but few supporting studies have utilized prospect i ve design s and adequate control . The aim of this study was to estimate the relative influence of symptoms and neurocognitive deficits on the development of social behavior skills in a cohort of individuals with schizophrenia or schizoaffective disorder recovering from acute symptom exacerbations . Forty-six individuals were recruited upon discharge from an inpatient unit and completed assessment s of  symptoms , neurocognitive function , and social behavior  at 3-month intervals for 1 year . Correlational analyses and r and om regression models were used to model social behavioral capacities longitudinally . Social behavior improved modestly ( 10 % improvements in ratings ) over the follow-up period for the group as a whole . Disorganized and negative symptoms , as well as neurocognitive deficits in short-term and working memory predicted changes in social behavior over time . Individuals with better working memory function showed significantly greater abilities to recover social behavior skills , whereas those with working memory deficits showed no functional improvement over time . Both symptoms and neurocognitive deficits are important determinants of functional outcome in schizophrenia . It is proposed that clinicians should consider neurocognitive thresholds for treatment response when developing rehabilitation plans Social functioning deficits ( e.g. , social skill , community functioning ) are a core feature of schizophrenia . These deficits are only minimally improved via the frontline treatments for schizophrenia ( e.g. medication , social skills training , cognitive-behavioral therapy ) . Social cognition is a promising treatment target in this regard as it may be more strongly related to social functioning outcomes than traditional neurocognitive domains [ Couture , S. , Penn , D.L. , Roberts , D.L. , 2006 . The functional significance of social cognition in schizophrenia : a review . Schizophrenia Bulletin ( Suppl . 1 ) , S-44 - 63 ] . Social cognition and interaction training ( SCIT ) is a 20-week , manualized , group treatment design ed to improve social functioning in schizophrenia by way of improved social cognition . This article reports preliminary data from a quasi-experimental study comparing SCIT + treatment as usual ( TAU ; n=20 ) to TAU alone  ( n=11 ) among out patients . Results using analysis of variance ( ANOVA ) suggest SCIT-related improvements in emotion perception and social skill UNLABELLED Biosocial models are preeminent in the study of schizophrenia , yet there has been little empirical testing of these models . OBJECTIVE This study provided the first test of a biosocial causal model of functional outcome in schizophrenia , using neurocognition , social cognition , social competence and social support as predictors of both global and specific domains of functional outcome . METHOD The design used baseline variables to predict both concurrent functional status and prospect i ve 12-month functional outcome . Subjects were recruited upon admission to outpatient community-based psychosocial rehabilitation programs shown in previous studies to be effective in improving functional outcomes . 139 individuals diagnosed with schizophrenia or schizoaffective disorder participated in the study ; 100 participants completed the 12-month assessment s.  Face-to-face interviews assessed neurocognitive functioning ( with five neuropsychological measures ) , social cognition ( as perception of emotion ) , social competence , social support , and functional outcome which consisted of items covering the domains of social , independent living , and work functioning . RESULTS Path analysis modeling showed that the proposed biosocial models had strong fit with the data , for both concurrent and 12-month global functional outcomes , with fit indices ranging from .95 to .98 . The model explained 21 % of the variance in concurrent global functional outcome , and 14 % of the variance in 12-month prospect i ve outcome . CONCLUSIONS The support for this model was strong , and it has implication s for underst and ing the causal factors related to functional outcome , as well as for intervention strategies for improving functional outcomes in schizophrenia Deficits in the ability to perceive facial and vocal emotion expression are common in schizophrenia . However , relatively little is known about how such deficits might affect functional outcomes . This prospect i ve study examined cross-sectional and longitudinal relationships between perception of emotion and aspects of psychosocial functioning , including family relationships , social relationships , work functioning , and independent living/self-care in 94 clinical ly stabilized schizophrenia out patients from five community-based rehabilitation programs .  Emotion perception ( facial emotion , voice emotion , and affect perception ) and psychosocial outcome ( Strauss and Carpenter Outcome Scale and Role Functioning Scale ) were assessed at baseline and after 12 months of psychosocial rehabilitation . Significant associations were found between perception of emotion and work functioning/independent living both cross-sectionally and prospect ively over the 12 months . Causal explanatory models suggested that perception of emotion might cause work functioning/independent living outcome over 1 year . The results remained significant when conceptual disorganization was statistically controlled . We did not find differences between men and women in the correlations between emotion perception and work functioning/independent living . Associations between social functioning/family relationships and perception of emotion were not significant . These findings suggest that emotion processing is a key determinant of work functioning/independent living for individuals with serious mental illness The purpose of this study was to assess how neurocognition and social cognition were associated with initial functional level and with rates of functional change in intensive community-based psychosocial rehabilitation interventions that have been shown to yield significant functional change for individuals diagnosed with schizophrenia . We also examined how service intensity was associated with rates of change and whether it served as a moderator of the relationship between functional change and both neurocognition and social cognition . The sample consisted of 125 individuals diagnosed with schizophrenia or schizoaffective disorder who were recruited upon admission to 1 of 4 community-based psychosocial rehabilitation facilities and were followed prospect ively for 12 months . One hundred and two subjects completed the 12-month protocol . The findings suggested that ( i ) the initial level of psychosocial functioning was related to both social cognition and neurocognition at baseline , ( ii ) when significant rehabilitative change occurs , higher neurocognition and social cognition scores at baseline predicted higher rates of functional change over the subsequent 12 months , ( iii ) greater service intensity was related to higher rates of improvement in functional outcome over time , and ( iv ) service intensity moderated the relationship between neurocognition and initial functional level and moderated the relationship between social cognition and the rates of functional change at a trend level . These findings have relevance to our underst and ing of the heterogeneity in functional rehabilitative outcomes , to our underst and ing of the conditions of rehabilitative change and for the design of psychosocial interventions in the community This study examined whether frontal-system impairments in schizophrenia occur independently of one another and whether they have distinct implication s for information processing , symptom severity , and adaptive functioning . We assessed 26 medication-free schizophrenic out patients and 18 normal control subjects on eight frontally mediated tasks , semantic information processing , IQ , the BPRS , and long-term psychosocial adaptation . Schizophrenic subjects showed three types of deficits , which were uncorrelated with one another : ( 1 ) Executive dysfunction ( inflexible problem solving ) was related to decreased use of expectancy during controlled semantic priming , lower intelligence , more severe negative symptoms and stereotyped mannerisms . ( 2 ) Disinhibition of responses ( to irrelevant stimuli ) was associated with increased automatic priming , a trend for more severe hallucinations , and was unrelated to intelligence . ( 3 ) Motor dyscoordination ( inaccurate , dysfluent motor sequencing ) was not related to semantic processing , intelligence , or symptoms . Furthermore , all three impairments were unrelated to generalized slowness , age , sex , illness length , or pre-washout neuroleptic dose . Two deficits accounted for aspects of long-term psychosocial adaptation , even after statistical correction for IQ : Executive dysfunction was associated with younger illness onset , poor purpose fulness and planning , impaired social relations , and lower global functioning . Motor dyscoordination was associated with poor treatment outcome and restricted educational advancement . Furthermore , executive and motor deficits interacted significantly ; subjects who had both deficits showed the least favorable treatment outcome . These findings are neither consistent with generalized impairment nor with a unitary ' frontal syndrome ' in schizophrenia . They provide preliminary evidence for at least three frontal-system deficits ( dorsolateral , orbital , and premotor ) , which are dissociable from one another , can occur without general intellectual impairment , and have distinct implication s for long-term adaptive functioning The purpose of this cross-sectional study was to examine the relationships between neurocognitive deficits and quality of life for patient with schizophrenia . Fifty-seven schizophrenic out patients ( 38 men and 19 women ) were assessed for neurocognitive deficits using the Wisconsin Card Sorting Test ( WCST ) and all patients completed the PCASEE ( P = physical , C = cognitive , A = affective , S = social , E = economic-social , and E = ego functions ) question naire to assess their quality of life . We assessed psychiatric symptoms using the Schedule for the Assessment of Positive Symptoms ( SAPS ) and the Schedule for the Assessment of Negative Symptoms ( SANS ) . We rated the Abnormal Involuntary Movement Scale ( AIMS ) for extrapyramidal side effects . Pearson correlational analyses were conducted to assess the relationships among measures of quality of life , neurocognitive functioning , symptoms , and extrapyramidal side effects . There were significant relationships among the total score of the PCASEE question naire and the SANS total score and the AIMS total score ( P<.001 ) . Small but significant associations were found among the total score of the PCASEE question naire and the SAPS total score and a number of nonperseverative errors ( P<.05 ) . Negative symptoms and extrapyramidal side effects in schizophrenia appear to have direct impact on the patient 's perceived quality of life BACKGROUND Deficits in social cognition and neurocognition are believed to underlie schizophrenia disability . Attempts at rehabilitation have had circumscribed effects on cognition , without concurrent improvement in broad aspects of behavior and adjustment . OBJECTIVE To determine the differential effects of cognitive enhancement therapy ( a recovery-phase intervention ) on cognition and behavior compared with state-of-the-art enriched supportive therapy . DESIGN A 2-year , r and omized controlled trial with neuropsychological and behavioral assessment s completed at baseline and at 12 and 24 months . SETTING An outpatient research clinic housed in a medical center 's comprehensive care service for patients with severe mental illness . PATIENTS A total of 121 symptomatically stable , non-substance-abusing but cognitively disabled and chronically ill patients with schizophrenia or schizoaffective disorder . INTERVENTIONS Cognitive enhancement therapy is a multidimensional , developmental approach that integrates computer-assisted training in neurocognition with social cognitive group exercises . Enriched supportive therapy fosters illness management through applied coping strategies and education . MAIN OUTCOME MEASURES Six highly reliable summary measures --Processing Speed , Neurocognition , Cognitive Style , Social Cognition , Social Adjustment and Symptoms -- were tested using analysis of covariance and linear trend analysis . RESULTS At 12 months , robust  cognitive enhancement therapy effects were observed on the Neurocognition and Processing Speed composites ( P<.003 ) , with marginal effects observed on the behavioral composites . By 24 months , differential  cognitive enhancement therapy effects were again observed for the 2 neuropsychological composites and for Cognitive Style ( P=.001 ) , Social Cognition ( P=.001 ) , and Social Adjustment ( P=.01 ) . As expected , no differences were observed on the residual Symptoms composite . Effects were unrelated to the type of antipsychotic medication received . Enriched supportive therapy also demonstrated statistically significant within-group effect sizes , suggesting that supportive psychotherapy can also have positive , although more modest , effects on cognitive deficits . CONCLUSION Many cognitive deficits and related behav 
    Output:
    
Overall , social cognition was more strongly associated with community functioning than neurocognition , with the strongest associations being between theory of mind and functional outcomes .