The disruption of psychosocial functioning (PSF) is currently listed as one of the DSM IV diagnostic criteria for schizophrenia and PSF is increasingly recognized as an important determinant of successful treatment of the disease. Many factors influence patients psychosocial functioning; they can be grouped into illness related factors, context related factors and factors related to individual resources. Among illness related factors, negative symptoms and cognitive impairment are the most largely investigated domains. Evidence has been provided that negative symptoms are related to a poor psychosocial outcome; however, whether negative symptoms contribute to patients disability or represent its consequence is an open issue. Moreover, the study of relationships between negative symptoms and psychosocial functioning is further complicated by the overlap between the two domains in several assessment instruments and by the definition of negative symptoms as a unitary construct.

Cognitive impairment has also been reported in association with poor psychosocial functioning. It is debated whether a global impairment in cognition is relevant to poor functioning in the real life, or deficit of specific cognitive domains (including social cognition) play the most important role, or whether specific cognitive deficits are actually responsible for the impairment of specific aspect of psychosocial functioning.

The need for future treatments to target negative symptoms and cognitive impairment for their direct and indirect impact on psychosocial functioning will be highlighted.