Volume-Based Stereotactic Radiofrequency Thermocoagulation for Drug-Resistant Focal Epilepsy: Preliminary Multicenter Report From Japan.

Individuals with schizophrenia/schizoaffective disorder (SZ) show robust deficits in social cognition that are associated with symptom severity and functional outcomes (). These deficits span both lower-level processes like facial and vocal emotion recognition, and higher-level processes like mentalizing (; ). Given limited treatment options for social cognitive deficits (), understanding their mechanisms and risk factors has become a research priority. As SZ has a strong genetic component (; ), examining how social cognitive deficits manifest across the spectrum of genetic liability could inform strategies for early detection and intervention. Social cognitive deficits also characterize bipolar disorder (BD), particularly in patients with psychotic features, though they are typically less severe than in SZ (; ). A meta-analysis of 26 studies confirmed that BD patients outperform SZ patients in social cognition, with psychotic features associated with greater impairment (). These patterns mirror broader neurocognitive findings, suggesting shared vulnerability across psychotic disorders (). Critically, social cognitive deficits extend to biological relatives of both patient groups, supporting their role as markers of genetic liability. Meta-analyses document emotion recognition and mentalizing deficits in first-degree relatives of SZ patients (29 studies; ) and BD patients (17 studies; ). However, these studies have been constrained by small samples (median = 27–34 per group) and reliance on single tasks, which are vulnerable to measurement error and cannot distinguish domain-general from domain-specific deficits (; ).