Impact of intelligence on social cognition in mentally disordered offenders: preliminary evidence in schizophrenia and personality disorders

Introduction: Social cognition (SC) allows individuals to perceive, interpret, and react to intentions and behaviors of others. Forensic psychiatry patients show impaired SC, leading to emergence of violent behaviors. This impairment may differ according to patients' intelligence quotient and psychiatric diagnosis (schizophrenia spectrum vs. personality disorders). Aims: : We retrospectively retrieved and analyzed data in a preliminary sample of 75 offenders following court-ordered psychiatric treatment in Switzerland. Emotional SC was assessed using a facial emotions' recognition task and cognitive SC was assessed with theory of mind comics picture stories. Multiple logistic regression models were applied to identify protective and risk factors of cognitive SC and emotional SC. Results: 39.2% of the offenders presented cognitive SC and 25.3% emotional SC impairment. Higher intelligence quotient was the unique 10-fold protective factor for cognitive SC, independently of psychiatric diagnoses and criminal history. In contrast, for emotional SC, average intelligence and PD disorder acted as protective factors compared to schizophrenia and intellectual deficiency, while foreign nationality acted as risk factor. Notably, neither recidivism nor the violent or multiple nature of crimes were related to SC. Discussion: Clinicians should consider patients' level of intelligence and include differential emotional and cognitive SC assessments, when referring mentally disordered offenders for SC training to improve their prosocial skills.