A meta-analytic review of the relationship between neurocognition, metacognition and functional outcome in schizophrenia

Previous research has identified that neurocognition predicts functional outcome in schizophrenia to a greater extent than psychopthology. More contemporary authors have begun to explore the role of metacognition as a mediating variable between neurocognition and functional outcome. The present review sought to extend the known work by synthesising the results reported in individual studies to see if these results are consistently found across samples. Relevant search strategies were entered into Medline (PubMed), PsychINFO and Embase. The present meta-analysis encompassed 17 studies (N=1060) investigating the relationship between neurocognition and metacognition and 7 studies investigating the relationship between metacognition and functional outcome (N=645). A small-to-moderate mean effect size was found between neurocognition and metacognition (effect size range .13 -.58,) and a small-to-moderate effect size was found between metacognition and functional outcome (range .17 - .57). Study findings suggest that relationships between variables are consistently found across samples and that future research should focus on investigating this relationship at earlier stages of illness, in female cohorts and across cognitive domains. Greater investigation is required in functional outcome, differentiating the impact of metacognition on functional capacity and other domains of functional outcome.