Supportive Family Environments can Improve Treatment Compliance, Social Cognition, Brain Activity in Patients with Schizophrenia – A Pilot Study

Peiwei Shan, Gongying Li, Deguo Jiang, Ce Chen, Lina Wang, Hongjun Tian, Ranli Li, Xiaoyan Ma, Min Chen, Xiaodong Lin, Chuanjun Zhuo, Jianjing Zhang.


Background: Supportive family environments can improve the prognosis of patients with schizophrenia by enhancing treatment compliance, social cognition, and functional brain alterations. This study aimed to investigate the impact of supportive family environments on treatment compliance, social cognition, and the associated brain activity features in patients with schizophrenia.

Methods: Patients with schizophrenia (n=40) and healthy controls (n=25) were recruited, and divided into two groups, including (1) supportive family environment group and (2) non-supportive (poor) family environment group. The Adherence Rating Scale (MARS) was adopted to assess treatment compliance. The Basic Empathy Scale (BES) and Social Attribution Task-Multiple Choice were used to assess social cognition. The Positive and Negative Symptoms Scale (PANSS) was used to assess the severity of schizophrenic symptoms. gFCD was used to assess functional brain alterations.

Results: Compared to patients with non-supportive family environments, patients with supportive family environments showed better treatment compliance [8.5 (1.2) vs. 4.5 (1.5), P<0.05] and improved social cognition, as indicated through BES [72.8 (9.0) vs. 64.53 (7.5), P<0.05] and SAT-MC scores [11.50 (4.6) vs. 8.7 (5.0), P<0.05]. Higher brain activity (i.e., increased gFCD) was detected in the medial temporal gyrus, temporoparietal junction, anterior insula cortex, and lingual gyrus.

Conclusions: Findings from this pilot study indicate that supportive family environments not only improve the treatment compliance and social cognition of patients with schizophrenia, but also improve functional brain activity in regions associated with the social cognition processing circuit. Hence, a supportive family environment may substantially impact the prognosis of schizophrenia.

Keywords: Schizophrenia, supportive family environment, treatment compliance, social cognition, brain activity