Background Emotion processing (EP) is impaired in individuals with psychosis and associated with social functioning; however, it is unclear how symptoms fit into this relationship. The aim of this systematic review and meta-analysis was to examine interrelationships between EP, symptoms, and social functioning, test whether different symptom domains mediate the relationship between EP and social functioning, and examine the moderating effects of illness stage and EP task type. Study Design MEDLINE, Embase, and PsycINFO databases were searched for studies that included individuals with psychosis and reported correlations between EP, symptom domains (positive, negative, depressive, and disorganization), and social functioning. Random effects meta-analyses determined the strength of correlations, and subgroup analyses included illness stage and EP task type (lower- vs higher-level processing). Meta-analytic structural equation models tested whether symptom domains mediated the relationship between EP and social functioning. Results There was a small relationship (r = .18) between EP and social functioning. Positive, negative, and disorganization symptoms mediated this relationship, although indirect effects were small. Higher-level EP tasks were more strongly associated with negative symptoms than lower-level tasks. Relationships between EP and both social functioning and positive symptoms were smaller in the first episode of psychosis than in established illness. Conclusions The mediating relationship suggests that EP not only influences social dysfunction directly but contributes to negative and disorganization symptoms, which in turn impair social functioning. This pathway suggests that targeting negative and disorganization symptoms may ultimately improve social outcomes for individuals with psychosis. Future research, particularly in early psychosis, is needed to determine other factors impacting these interrelationships.

中文翻译：

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情绪处理及其与精神障碍社会功能和症状的关系：系统回顾和荟萃分析


背景 精神病患者的情绪处理（EP）受到损害，并且与社会功能相关；然而，目前尚不清楚症状如何与这种关系相适应。本系统综述和荟萃分析的目的是检查 EP、症状和社会功能之间的相互关系，测试不同症状领域是否介导 EP 和社会功能之间的关系，并检查疾病阶段和 EP 任务类型的调节作用。研究设计 在 MEDLINE、Embase 和 PsycINFO 数据库中搜索了包括精神病患者在内的研究，并报告了 EP、症状领域（积极、消极、抑郁和紊乱）和社会功能之间的相关性。随机效应荟萃分析确定了相关性的强度，亚组分析包括疾病阶段和 EP 任务类型（较低水平与较高水平的处理）。荟萃分析结构方程模型测试了症状域是否介导 EP 和社会功能之间的关系。结果 EP 和社会功能之间存在很小的关系 (r = .18)。积极、消极和混乱症状介导了这种关系，尽管间接影响很小。与较低级别的任务相比，较高级别的 EP 任务与阴性症状的相关性更强。在精神病首次发作时，EP 与社会功能和阳性症状之间的关系比已确诊疾病时的关系更小。结论 中介关系表明 EP 不仅直接影响社会功能障碍，而且会导致消极和紊乱症状，进而损害社会功能。 该途径表明，针对消极和混乱症状可能最终会改善精神病患者的社会结果。未来的研究，特别是早期精神病，需要确定影响这些相互关系的其他因素。