Pragmatic impairment is diffused in schizophrenia spectrum disorders, but the literature still debates its neurocognitive underpinnings. This systematic review and meta-analysis aimed to investigate the neurocognitive correlates of pragmatic disorders in schizophrenia and determine the weight of social cognition and executive functioning on such disorders. Of the 2,668 records retrieved from the literature, 16 papers were included in the systematic review, mostly focused on non-literal meanings and discourse production in schizophrenia. Ten studies were included in the meta-analysis: pragmatics was moderately associated with both social cognition and executive functions (especially inhibition), but the link with social cognition was stronger. The mediation analysis showed that social cognition mediated the relationship between executive functions and pragmatics. Based on this, we proposed a hierarchical neurocognitive model where pragmatics stems from social cognition, while executive functions are the fertile ground supporting the other two domains, and we discuss its theoretical and clinical implications.

中文翻译：

---

权衡社会认知和执行功能在精神分裂症谱系中语用学中的作用：系统评价和荟萃分析

语用障碍在精神分裂症谱系障碍中广泛存在，但文献仍然对其神经认知基础存在争议。这项系统回顾和荟萃分析旨在调查精神分裂症语用障碍的神经认知相关性，并确定社会认知和执行功能对此类障碍的影响。从文献中检索到的 2,668 条记录中，有 16 篇论文被纳入系统评价，主要集中在精神分裂症的非字面意义和话语产生方面。荟萃分析中纳入了十项研究：语用学与社会认知和执行功能（尤其是抑制）有中等程度的相关性，但与社会认知的联系更强。中介分析表明，社会认知在执行功能和语用之间的关系中起到中介作用。基于此，我们提出了一种分层神经认知模型，其中语用学源于社会认知，而执行功能是支持其他两个领域的沃土，我们讨论了其理论和临床意义。