Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University and Mondriaan Zorggroep, Section Social Cognition, Heerlen, the Netherlands
Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, the Netherlands
Centre Hospitalier Le Vinatier, Université Lyon I, Institut des Sciences Cognitives, Centre National de la Recherche Scientifique, France
Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University and Mondriaan Zorggroep, Section Social Cognition, Heerlen, the Netherlands
Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, the Netherlands
Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, the Netherlands, and Division of Psychological Medicine, Institute of Psychiatry, London, UK, and Mondriaan Zorggroep, Section Social Cognition, Heerlen, the Netherlands
Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, the Netherlands
Correspondence: Dr Lydia Krabbendam, Department of Psychiatry and Neuropsychology, Maastricht University, PO BOX 616 (VIJV), 6200 MD Maastricht, the Netherlands. Tel: ++31 43 3688682; fax: ++31 43 3688689; email: l.krabbendam{at}sp.unimaas.nl
Background A disorder of self-monitoring may underlie the positive symptoms of psychosis. The cognitive mechanisms associated with these symptoms may also be detectable in individuals at risk of psychosis.
Aims To investigate (a) whether patients with psychosis show impaired self-monitoring, (b) to what degree this is associated with positive symptoms, and (c) whether thisis associated with liability to psychotic symptoms.
Method The sample included: individuals with a lifetime history of non-affective psychosis (n=37), a genetically defined risk group (n=41), a psychometrically defined risk group (n=40), and control group (n=49). All participants carried out an action–recognition task.
Results Number of action–recognition errors was associated with psychosis risk (OR linear trend over 3 levels:1.12, 95% CI1.04–1.20) and differential error rate was associated with the degree of delusional ideation in a dose–response fashion (OR linear trend over 3 levels:1.13, 95% CI1.00–1.26).
Conclusions Alterationsin self-monitoring are associated with psychosis with evidence of specificity for delusional ideation. In the risk state, this is expressed more as failure to recognise self-generated actions, whereasin illness failure to recognise alien sources come to the fore.