Neurocognition, Metacognition, and Outcome in Schizophrenia Spectrum Disorders: A Scoping Review

Neurocognitive and metacognitive impairments are well-documented in schizophrenia spectrum disorders (SSDs). However, the relationship between these two domains remains underexplored, despite increasing interest in their combined impact on recovery and functional outcomes. Neurocognition refers to processes such as attention, memory, and executive functioning, and the neural systems that support these processes, both of which are frequently abnormal in SSDs and contribute to significant functional difficulties. Metacognition, in contrast, refers to the capacity to reflect on and integrate thoughts, emotions, and experiences into a coherent understanding of oneself and others. Although both domains are often studied in isolation, emerging evidence suggests a potential interdependence between neurocognition and metacognition, particularly regarding their influence on outcome. This scoping review explores empirical studies examining associations between neurocognition and metacognition in individuals with SSDs, specifically in the context of functional outcomes. We aim to clarify how these domains interact and explore their combined implications for recovery-oriented interventions and clinical practice. Findings may inform more integrated models of cognition and guide the development of dual-targeted treatment approaches to improve functional recovery in SSDs.