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Association of empathy with clinical symptoms and cognitive function in chronic schizophrenia patients with and without suicide attempts

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Abstract

Cognitive impairment is recognized as a risk factor for suicide in schizophrenia (SZ) patients. Despite empathy being an important aspect of social cognition, the association between suicidal behavior and empathy has received little attention. We aimed to compare empathy and neurocognition in SZ patients with and without suicide attempts (SAs), and to explore the relationship between empathy, neurocognition, and clinical symptoms in SZ patients with and without SAs. Data on SAs and socio-demographic characteristics were collected from 628 chronic SZ patients. The patients’ symptomatology was measured by the Positive and Negative Syndrome Scale (PANSS). Empathy and neurocognition were assessed with the Interpersonal Reactivity Index (IRI) and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), respectively. Patients with SAs performed better on all IRI domains (except for Perspective Taking) and total scores. Regression results showed that negative symptoms, positive symptoms, and duration of illness were independently associated with IRI total score in patients without SAs (adjusted R2 = 0.048). In patients without SAs, negative symptoms, general psychopathology, education, age, and sex were independently associated with RBANS total score (adjusted R2 = 0.265), while in patients with SAs, education, PANSS total score, and age at onset were independently associated with RBANS total score (adjusted R2 = 0.456). Our results show that SZ patients with SAs may have better empathic performance than patients without SAs. In chronic SZ patients, negative and positive symptoms may have different effects on cognition in the SAs and non-SAs groups.

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References

  1. Grigoriou M, Upthegrove R (2020) Blunted affect and suicide in schizophrenia: a systematic review. Psychiatry Res 293:113355. https://doi.org/10.1016/j.psychres.2020.113355

    Article  PubMed  Google Scholar 

  2. Bushe CJ, Taylor M, Haukka J (2010) Review: Mortality in schizophrenia: a measurable clinical endpoint. J Psychopharmacol 24:17–25. https://doi.org/10.1177/1359786810382468

    Article  PubMed  PubMed Central  Google Scholar 

  3. Sher L, Kahn RS (2019) Family interventions and prevention of suicide in first-episode schizophrenia. Acta Psychiatr Scand 139:484–484. https://doi.org/10.1111/acps.13018

    Article  CAS  PubMed  Google Scholar 

  4. Bani-Fatemi A, Graff A, Zai C, Strauss J, De Luca V (2016) GWAS analysis of suicide attempt in schizophrenia: main genetic effect and interaction with early life trauma. Neurosci Lett 622:102–106. https://doi.org/10.1016/j.neulet.2016.04.043

    Article  CAS  PubMed  Google Scholar 

  5. Aydın M, İlhan BC, Tekdemir R, Çokünlü Y, Erbasan V, Altınbaş K (2019) Suicide attempts and related factors in schizophrenia patients. Saudi Medical Journal 40:475–482. https://doi.org/10.15537/smj.2019.5.24153

  6. Fleischhacker WW, Kane JM, Geier J, Karayal O, Kolluri S, Eng SM (2014) Completed and attempted suicides among 18,154 subjects with schizophrenia included in a large simple trial. J Clin Psychiatry 75:184–190. https://doi.org/10.4088/JCP.13m08563

    Article  Google Scholar 

  7. Carlborg A, Jokinen J, Nordström AL, Jönsson EG, Nordström P (2010) Attempted suicide predicts suicide risk in schizophrenia spectrum psychosis. Nord J Psychiatry 64:68–72. https://doi.org/10.3109/08039480903274431

    Article  PubMed  Google Scholar 

  8. Hor J, Taylor M (2010) Suicide and schizophrenia: a systematic review of rates and risk factors. J Psychopharmacol 24:81–90. https://doi.org/10.1177/1359786810385490

    Article  PubMed  PubMed Central  Google Scholar 

  9. Hammoudeh S, Ghuloum S, Mahfoud Z, Opler M, Khan A, Yehya A, Abdulhakam A, Al-Mujalli A, Hani Y, Elsherbiny R, Al-Amin H (2016) Reliability, validity and factorial structure of the Arabic version of the international suicide prevention trial (InterSePT) scale for suicidal thinking in schizophrenia patients in Doha. Qatar BMC Psychiatry 16:437. https://doi.org/10.1186/s12888-016-1155-4

    Article  PubMed  Google Scholar 

  10. Zheng W, Zhang QE, Cai DB, Ng CH, Ungvari GS, Ning YP, Xiang YT (2018) Neurocognitive dysfunction in subjects at clinical high risk for psychosis: a meta-analysis. J Psychiatr Res 103:38–45. https://doi.org/10.1016/j.jpsychires.2018.05.001

    Article  PubMed  Google Scholar 

  11. Villa J, Choi J, Kangas JL, Kaufmann CN, Harvey PD, Depp CA (2018) Associations of suicidality with cognitive ability and cognitive insight in outpatients with schizophrenia. Schizophr Res 192:340–344. https://doi.org/10.1016/j.schres.2017.06.013

    Article  PubMed  Google Scholar 

  12. Barrett EA, Sundet K, Simonsen C, Agartz I, Lorentzen S, Mehlum L, Melle I (2011) Neurocognitive functioning and suicidality in schizophrenia spectrum disorders. Compr Psychiatry 52:156–163. https://doi.org/10.1016/j.comppsych.2010.06.001

    Article  PubMed  Google Scholar 

  13. Yin Y, Tong J, Huang J, Tian B, Chen S, Cui Y, An H, Tan S, Wang Z, Yang F, Tian L, Tong Y, Hong LE, Tan Y (2020) Suicidal ideation, suicide attempts, and neurocognitive dysfunctions among patients with first-episode schizophrenia. Suicide Life Threaten Behav 50:1181–1188. https://doi.org/10.1111/sltb.12689

    Article  Google Scholar 

  14. Chuang SP, Wu JYW, Wang CS (2021) Metacognitive beliefs, cognitive functioning, psychiatric symptoms and empathy in people with schizophrenia. Neuropsychiatr Dis Treat 17:2209–2217. https://doi.org/10.2147/NDT.S313932

    Article  PubMed  PubMed Central  Google Scholar 

  15. Bartochowski Z, Gatla S, Khoury R, Al-Dahhak R, Grossberg GT (2018) Empathy changes in neurocognitive disorders: a review. Ann Clin Psychiatry 30:220–232

    PubMed  Google Scholar 

  16. Bonfils KA, Lysaker PH, Minor KS, Salyers MP (2016) Affective empathy in schizophrenia: a meta-analysis. Schizophr Res 175:109–117. https://doi.org/10.1016/j.schres.2016.03.037

    Article  PubMed  Google Scholar 

  17. Cuff BMP, Brown SJ, Taylor L, Howat DJ (2014) Empathy: a review of the concept. Emot Rev 8:144–153. https://doi.org/10.1177/1754073914558466

    Article  Google Scholar 

  18. Michaels TM, Horan WP, Ginger EJ, Martinovich Z, Pinkham AE, Smith MJ (2014) Cognitive empathy contributes to poor social functioning in schizophrenia: evidence from a new self-report measure of cognitive and affective empathy. Psychiatry Res 220:803–810. https://doi.org/10.1016/j.psychres.2014.08.054

    Article  PubMed  Google Scholar 

  19. Horan WP, Reise SP, Kern RS, Lee J, Penn DL, Green MF (2015) Structure and correlates of self-reported empathy in schizophrenia. J Psychiatr Res 66–67:60–66. https://doi.org/10.1016/j.jpsychires.2015.04.016

    Article  PubMed  Google Scholar 

  20. Wang W, Zhou Y, Wang J, Xu H, Wei S, Wang D, Wang L, Zhang XY (2020) Prevalence, clinical correlates of suicide attempt and its relationship with empathy in patients with schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 99:109863. https://doi.org/10.1016/j.pnpbp.2020.109863

    Article  PubMed  Google Scholar 

  21. Fulford D, Niendam TA, Floyd EG, Carter CS, Mathalon DH, Vinogradov S, Stuart BK, Loewy RL (2013) Symptom dimensions and functional impairment in early psychosis: more to the story than just negative symptoms. Schizophr Res 147:125–131. https://doi.org/10.1016/j.schres.2013.03.024

    Article  PubMed  PubMed Central  Google Scholar 

  22. Huang Y, Wu K, Jiang R, Zeng X, Zhou S, Guo W, Feng Y, Zou C, Li H, Li T, Islam MA, Habtewold TD, van Es FD et al (2018) Long-term cognitive trajectories and heterogeneity in patients with schizophrenia and their unaffected siblings. Acta Psychiatr Scand 138:591–604. https://doi.org/10.1111/acps.12961

    Article  Google Scholar 

  23. Lam BY, Raine A, Lee TM (2014) The relationship between neurocognition and symptomatology in people with schizophrenia: social cognition as the mediator. BMC Psychiatry 14:138. https://doi.org/10.1186/1471-244X-14-138

    Article  PubMed  PubMed Central  Google Scholar 

  24. Li AWY, Hui CLM, Lee EHM, Chang WC, Chan SKW, Chen EYH (2019) Gender differences in correlates of cognition in first-episode psychosis. Psychiatry Res 271:412–420. https://doi.org/10.1016/j.psychres.2018.12.011

    Article  PubMed  Google Scholar 

  25. Smith MJ, Horan WP, Cobia DJ, Karpouzian TM, Fox JM, Reilly JL, Breiter HC (2014) Performance-based empathy mediates the influence of working memory on social competence in schizophrenia. Schizophr Bull 40:824–834. https://doi.org/10.1093/schbul/sbt084

    Article  PubMed  Google Scholar 

  26. Abram SV, Wisner KM, Fox JM, Barch DM, Wang L, Csernansky JG, MacDonald AW 3rd, Smith MJ (2017) Fronto-temporal connectivity predicts cognitive empathy deficits and experiential negative symptoms in schizophrenia. Hum Brain Mapp 38:1111–1124. https://doi.org/10.1002/hbm.23439

    Article  PubMed  Google Scholar 

  27. Achim AM, Ouellet R, Roy MA, Jackson PL (2011) Assessment of empathy in first-episode psychosis and meta-analytic comparison with previous studies in schizophrenia. Psychiatry Res 190:3–8. https://doi.org/10.1016/j.psychres.2010.10.030

    Article  PubMed  Google Scholar 

  28. Liu J, Tian Y, Wei S, Wang W, Wang D, Zhou H, Zhang X (2022) Association of empathy with clinical symptoms and cognitive function in Chinese chronic schizophrenia patients with and without deficit syndrome. Prog Neuropsychopharmacol Biol Psychiatry 119:110592. https://doi.org/10.1016/j.pnpbp.2022.110592

    Article  PubMed  Google Scholar 

  29. Kao YC, Liu YP, Cheng TH, Chou MK (2011) Cigarette smoking in outpatients with chronic schizophrenia in Taiwan: relationships to socio-demographic and clinical characteristics. Psychiatry Res 190:193–199. https://doi.org/10.1016/j.psychres.2011.05.016

    Article  PubMed  Google Scholar 

  30. Kay SR, Fiszbein A, Opler LA (1987) The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 13:261–276. https://doi.org/10.1093/schbul/13.2.261

    Article  CAS  PubMed  Google Scholar 

  31. Randolph C, Tierney MC, Mohr E, Chase TN (1998) The repeatable battery for the assessment of neuropsychological status (RBANS): preliminary clinical validity. J Clin Exp Neuropsychol 20:310–319. https://doi.org/10.1076/jcen.20.3.310.823

    Article  CAS  PubMed  Google Scholar 

  32. Zhang B, Tan Y, Zhang W, Wang Z, Yang G, Shi C, Zhou D (2008) Repeatable battery for the assessment of neuropsychological status as a screening test in Chinese: reliability and validity. Chin Ment Health J 22:865–869. https://doi.org/10.5114/aoms.2011.25561

    Article  Google Scholar 

  33. Bonfils A, Lysaker H, Minor S, Salyers P (2017) Empathy in schizophrenia: a meta-analysis of the Interpersonal Reactivity Index. Psychiatry Res 249:293–303. https://doi.org/10.1016/j.psychres.2016.12.033

    Article  PubMed  Google Scholar 

  34. Davis MH (1983) Measuring individual differences in empathy: evidence for a multidimensional approach. J Pers Soc Psychol 44:113–126. https://doi.org/10.1037/00223514.44.1.113

    Article  ADS  Google Scholar 

  35. Rong X, Sun B, Huang X, Cai M, Li W (2010) Reliabilities and validities of Chinese version of interpersonal reactivity index. Chin Mental Health J 18:158–160. https://doi.org/10.16128/j.cnki.1005-3611.2010.02.020

  36. Faul F, Erdfelder E, Lang G, Buchner A (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39(2):175–191. https://doi.org/10.3758/BF03193146

    Article  PubMed  Google Scholar 

  37. Wang D, Zhang X (2021) Association between empathy and clinical symptoms in chronic schizophrenia: a large sample study based on Chinese Han population. J Psychiatr Res 139:106–112. https://doi.org/10.1016/j.jpsychires.2021.05.046

    Article  PubMed  Google Scholar 

  38. Cohen AS, Minor KS (2010) Emotional experience in patients with schizophrenia revisited: meta-analysis of laboratory studies. Schizophr Bull 36:143–150. https://doi.org/10.1093/schbul/sbn061

    Article  PubMed  Google Scholar 

  39. Van Orden KA, Witte TK, Cukrowicz KC, Braithwaite SR, Selby EA, Joiner TE (2010) The interpersonal theory of suicide. Psychol Rev 117:575–600. https://doi.org/10.1037/a0018697

    Article  PubMed  PubMed Central  Google Scholar 

  40. Hwang JP, Lee TW, Tsai SJ, Chen TJ, Yang CH, Lirng JF, Tsai CF (2010) Cortical and subcortical abnormalities in late-onset depression with history of suicide attempts investigated with MRI and voxel-based morphometry. J Geriatr Psychiatry Neurol 23:171184. https://doi.org/10.1177/0891988710363713

    Article  Google Scholar 

  41. Li Y, Zhang T, Li W, Zhang J, Jin Z, Li L (2020) Linking brain structure and activation in anterior insula cortex to explain the trait empathy for pain. Hum Brain Mapp 41:1030–1042. https://doi.org/10.1002/hbm.24858

    Article  PubMed  Google Scholar 

  42. Zhang XY, Du X, Yin G, Zhang Y, Chen D, Xiu M, Soares JC (2018) Prevalence and clinical correlates of and cognitive function at the time of suicide attempts in first-episode and drug-naive patients with schizophrenia. J Clin Psychiatry 79:17m11797. https://doi.org/10.4088/JCP.17m11797

    Article  PubMed  Google Scholar 

  43. Dickerson F, Schroeder J, Stallings C, Origoni A, Katsafanas E, Schwienfurth LA et al (2014) A longitudinal study of cognitive functioning in schizophrenia: clinical and biological predictors. Schizophr Res 156:248–253

    Article  PubMed  Google Scholar 

  44. Van Heeringen K, Mann JJ (2014) The neurobiology of suicide. Lancet Psychiatry 1:63–72

    Article  PubMed  Google Scholar 

  45. Dai Q, Wang D, Wang J, Xu H, Andriescue E, Wu E et al (2021) Suicide attempts in Chinese Han patients with schizophrenia: Cognitive, demographic, and clinical variables. Braz J Psychiatry 43(1):29–34. https://doi.org/10.1590/1516-4446-2020-0900

    Article  PubMed  Google Scholar 

  46. Canal-Rivero M, Lopez-Morinigo JD, Setien-Suero E, Ruiz-Veguilla M, Ayuso-Mateos JL, Ayesa-Arriola R et al (2018) Predicting suicidal behaviour after first episode of non-affective psychosis: the role of neurocognitive functioning. Eur Psychiatry 53:52–57

    Article  CAS  PubMed  Google Scholar 

  47. Barrett A, Mork E, Faerden A, Nesvag R, Agartz I, Andreassen A, Melle I (2015) The development of insight and its relationship with suicidality over one year follow-up in patients with first episode psychosis. Schizophr Res 162(1–3):97–102

    Article  PubMed  Google Scholar 

  48. Verma D, Srivastava K, Singh K, Bhatia T, Deshpande N (2016) Lifetime suicide intent, executive function and insight in schizophrenia and schizoaffective disorders. Schizophr Res 178(1–3):12–16

    Article  PubMed  PubMed Central  Google Scholar 

  49. Iancu I, Bodner E, Roitman S, Piccone Sapir A, Poreh A, Kotler M (2010) Impulsivity, aggression and suicide risk among male schizophrenia patients. Psychopathology 43(4):223–229. https://doi.org/10.1159/000313520

    Article  PubMed  Google Scholar 

  50. Gomez-Duran L, Martin-Fumad C, Hurtado-Ruíz G (2012) Clinical and epidemiological aspects of suicide in patients with schizophrenia. Actas Esp Psiquiatr 40:33–45

    Google Scholar 

  51. Kjelby E, Sinkeviciute I, Gjestad R, Kroken A, Løberg M, Jørgensen A et al (2015) Suicidality in schizophrenia spectrum disorders: the relationship to hallucinations and persecutory delusions. Eur Psychiatry 30:830–836. https://doi.org/10.1016/j.eurpsy.2015.07.003

    Article  CAS  PubMed  Google Scholar 

  52. Grover E, Jones R, Bass J, McQuillin A (2022) The differential associations of positive and negative symptoms with suicidality. Schizophr Res 248:42–49. https://doi.org/10.1016/j.schres.2022.07.016

    Article  PubMed  Google Scholar 

  53. Ventriglio A, Gentile A, Bonfitto I, Stella E, Mari M, Steardo L, Bellomo A (2016) Suicide in the early stage of schizophrenia. Front Psychiatry 7:116. https://doi.org/10.3389/fpsyt.2016.00116

    Article  PubMed  PubMed Central  Google Scholar 

  54. Cassidy M, Yang F, Kapczinski F, Passos C (2018) Risk factors for suicidality in patients with schizophrenia: a systematic review, meta-analysis, and meta-regression of 96 studies. Schizophr Bull 44(4):787–797. https://doi.org/10.1093/schbul/sbx131

    Article  PubMed  Google Scholar 

  55. Jahn R, Bennett E, Park G, Gur E, Horan P, Kring M, Blanchard J (2016) The interactive effects of negative symptoms and social role functioning on suicide ideation in individuals with schizophrenia. Schizophr Res 170:271–277. https://doi.org/10.1016/j.schres.2015.12.011

    Article  PubMed  Google Scholar 

  56. Moseley P, Fernyhough C, Ellison A (2013) Auditory verbal hallucinations as atypical inner speech monitoring, and the potential of neurostimulation as a treatment option. Neurosci Biobehav Rev 37:2794–2805. https://doi.org/10.1016/j.neubiorev.2013.10.001

    Article  PubMed  PubMed Central  Google Scholar 

  57. Zhang R, Wei S, Chang M, Jiang X, Tang Y, Wang F (2020) Dorsolateral and ventrolateral prefrontal cortex structural changes relative to suicidal ideation in patients with depression. Acta Neuropsychiatrica 32:84–91. https://doi.org/10.1017/neu.2019.45

    Article  ADS  CAS  PubMed  Google Scholar 

  58. Lincoln TM, Mehl S, Kesting ML, Rief W (2011) Negative symptoms and social cognition: identifying targets for psychological interventions. Schizophr Bull 37:23–32. https://doi.org/10.1093/schbul/sbr066

    Article  Google Scholar 

  59. Lim J, Lee SA, Lam M, Rapisarda A, Kraus M, Keefe RSE, Lee J (2016) The relationship between negative symptom subdomains and cognition. Psychol Med 46:2169–2177. https://doi.org/10.1017/S0033291716000726

    Article  CAS  PubMed  Google Scholar 

  60. Brunet-Gouet E, Myszkowski N, Ehrminger M, Urbach M, Aouizerate B, Brunel L, Roux P (2019) Confirmation of a two-factor solution to the questionnaire of cognitive and affective empathy in a french population of patients with schizophrenia spectrum disorders. Front Psych 10:751. https://doi.org/10.3389/fpsyt.2019.00751

    Article  Google Scholar 

  61. Bagney A, Dompablo M, Santabarbara J, Moreno-Ortega M, Lobo A, Jimenez-Arriero MA, Rodriguez-Jimenez R (2015) Are negative symptoms really related to cognition in schizophrenia? Psychiatry Res 230:377–382. https://doi.org/10.1016/j.psychres.2015.09.022

    Article  PubMed  Google Scholar 

  62. Derntl B, Finkelmeyer A, Voss B, Eickhoff SB, Kellermann T, Schneider F, Habel U (2012) Neural correlates of the core facets of empathy in schizophrenia. Schizophr Res 136:70–81. https://doi.org/10.1016/j.schres.2011.12.018

    Article  PubMed  PubMed Central  Google Scholar 

  63. Gallagher M, Chiba AA (1996) The amygdala and emotion. Curr Opin Neurobiol 6:221–227. https://doi.org/10.1016/s0959-4388(96)80076-6

    Article  CAS  PubMed  Google Scholar 

  64. Young LT, Bezchlibnyk YB, Chen B, Wang JF, MacQueen GM (2004) Amygdala cyclic adenosine monophosphate response element binding protein phosphorylation in patients with mood disorders: effects of diagnosis, suicide, and drug treatment. Biol Psychiatry 55:570–577. https://doi.org/10.1016/j.biopsych.2003.10.023

    Article  CAS  PubMed  Google Scholar 

  65. Aleman A, Kahn RS (2005) Strange feelings: do amygdala abnormalities dysregulate the emotional brain in schizophrenia? Prog Neurobiol 77:283–298. https://doi.org/10.1016/j.pneurobio.2005.11.005

    Article  PubMed  Google Scholar 

  66. Frodl T, Meisenzahl E, Zetzsche T, Bottlender R, Born C, Groll C, Jager M, Leinsinger G, Hahn K, Moller HJ (2002) Enlargement of the amygdala in patients with a first episode of major depression. Biol Psychiatry 51:708–714. https://doi.org/10.1016/s0006-3223(01)01359-2

    Article  PubMed  Google Scholar 

  67. Spoletini I, Piras F, Fagioli S, Rubino IA, Martinotti G, Siracusano A, Caltagirone C, Spalletta G (2011) Suicidal attempts and increased right amygdala volume in schizophrenia. Schizophr Res 125:30–40. https://doi.org/10.1016/j.schres.2010.08.023

    Article  PubMed  Google Scholar 

  68. Harvey PD, Koren D, Reichenberg A, Bowie CR (2006) Negative symptoms and cognitive deficits: what is the nature of their relationship? Schizophr Bull 32:250–258. https://doi.org/10.1093/schbul/sbj011

    Article  PubMed  Google Scholar 

  69. Green MF, Horan WP, Lee J (2019) Nonsocial and social cognition in schizophrenia: current evidence and future directions. World Psychiatry 18:146–161. https://doi.org/10.1002/wps.20624

    Article  PubMed  PubMed Central  Google Scholar 

  70. Bora E, Gokcen S, Veznedaroglu B (2008) Empathic abilities in people with schizophrenia. Psychiatry Res 160:23–29. https://doi.org/10.1016/j.psychres.2007.05.017

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank all the participants who participated in this study. We would also like to thank the clinical psychiatrists for their significant contributions to this study.

Funding

This study was funded by CAS International Cooperation Research Program (153111KYSB20190004) and the CAS Key Lab of Mental Health.

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  1. CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China

    Zheng Ma, Yang Tian, Jiaxin Li, Junyao Liu, Dong-Mei Wang & Xiang-Yang Zhang

  2. Department of Psychology, University of Chinese Academy of Sciences, Beijing, China

    Zheng Ma, Yang Tian, Jiaxin Li, Junyao Liu, Dong-Mei Wang & Xiang-Yang Zhang

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Ma, Z., Tian, Y., Li, J. et al. Association of empathy with clinical symptoms and cognitive function in chronic schizophrenia patients with and without suicide attempts. Eur Arch Psychiatry Clin Neurosci (2024). https://doi.org/10.1007/s00406-024-01785-0

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