How do negative symptoms and social cognitive impairments overlap? Clustering analyses on patients living with schizophrenia-spectrum disorder

Negative symptoms and social cognition (SC) are intertwined in schizophrenia spectrum disorders (SSD), but the structure of this interaction is not yet fully understood. We employed cluster analyses to advance our understanding of the relationship between negative symptom severity and SC. We sought to identify discrete groups of patients as a function of two factors of negative symptoms-Motivation and Pleasure (MAP) and Expressivity (EXP)-and two domains of SC: emotion recognition (ER) and theory of mind (ToM). We conducted two cluster analyses to determine data-driven subgroups using two independent samples of SSD participants. The first was conducted with an open dataset (n = 296) and the second with a local sample (n = 138), to assess replicability. The first cluster analysis revealed a three-cluster solution. Both analyses highlighted distinct profiles: a 'Relatively Preserved' profile; a 'Combined Impairment' profile, with high negative symptoms and impaired ER and ToM; and a 'MAP' profile, with high MAP symptoms, some EXP symptoms, and slightly to moderately impaired ER and ToM. Reducing the heterogeneity in clinical presentations of SSD patients on these dimensions of negative symptoms and SC provides relevant information that could contribute to a more effective selection of interventions.