Social Cognition and Quality of Life in Chilean Patients With Schizophrenia Spectrum Disorders: A Mediational Model via Psychological Distress

Abstract

Introduction:

To examine whether deficits in social cognition (SC) are associated with poorer schizophrenia-related quality of life (SQoL) through psychological distress (PD) in adults with schizophrenia spectrum disorders, and to outline implications for community mental health and recovery-oriented care.

Methods:

We studied 175 outpatients (58% male; M age = 41.1) with schizophrenia spectrum disorders. Patients completed the GEOPTE Social Cognition subscale, the Kessler Psychological Distress Scale (K10) and the Schizophrenia Quality of Life Questionnaire (S-QoL-18). A structural equation model (SEM) with weighted least squares mean and variance adjusted estimation (WLSMV) tested direct and indirect effects (SC → PD → SQoL) across five domains.

Results:

Greater SC impairment correlated with higher PD (ρ = .48, p < .01) and with lower psychological/physical well-being, friendships and sentimental life (ρ = −.46 to −.24). Model fit was excellent (χ²/df = 1.50; RMSEA = 0.05, 90% CI [0.044, 0.064]; CFI/TLI = 0.96; SRMR = 0.06). In the SEM, SC showed strong direct effects on psychological well-being (β = −.77, p < .01) and moderate effects on physical well-being (β = −.34, p = .03), while indirect-only mediation via PD emerged for friendships and sentimental life (β_ind = −.14, p = .01; β_ind = −.25, p < .01).

Conclusions:

SC deficits are closely linked to both intrapersonal and interpersonal aspects of SQoL. These pathways support integrating SC assessment/remediation and PD management within community-based, recovery-oriented services, with particular attention to interpersonal domains of quality of life.