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Schizophr Res. 2014 Mar;153(1-3):54-9. doi: 10.1016/j.schres.2014.01.012. Epub 2014 Feb 4.

Metacognition, social cognition, and symptoms in patients with first episode and prolonged psychoses.

Author information

1
Indiana University School of Medicine, Department of Psychiatry, Indianapolis, IN, USA; Prevention and Recovery Center for Early Psychosis, Midtown Community Mental Health Centers, Wishard Hospital, Indianapolis, IN, USA; Larue D. Carter Memorial Hospital, IU Psychotic Disorders Research Program, Indianapolis, IN, USA. Electronic address: jvohs@iupui.edu.
2
Indiana University School of Medicine, Department of Psychiatry, Indianapolis, IN, USA; Roudebush VA Medical Hospital, Indianapolis, IN, USA.
3
Indiana University School of Medicine, Department of Psychiatry, Indianapolis, IN, USA; Prevention and Recovery Center for Early Psychosis, Midtown Community Mental Health Centers, Wishard Hospital, Indianapolis, IN, USA; Larue D. Carter Memorial Hospital, IU Psychotic Disorders Research Program, Indianapolis, IN, USA.
4
Roudebush VA Medical Hospital, Indianapolis, IN, USA; University of Indianapolis, School of Psychological Sciences, Indianapolis, IN, USA.
5
Roudebush VA Medical Hospital, Indianapolis, IN, USA.
6
Centro di Terapia Metacognitiva Interpersonale, Rome Italy.

Abstract

While it has been documented that persons with prolonged schizophrenia have deficits in metacognition and social cognition, it is less clear whether these difficulties are already present during a first episode. To explore this issue we assessed and compared metacognition using the Metacognition Assessment Scale-Abbreviated (MAS-A) and social cognition using the Eyes, Hinting and Bell-Lysaker Emotional Recognition Tests (BLERT) in participants with first episode psychosis (FEP; n=26), participants with a prolonged psychosis (n=72), and a psychiatric control group consisting of persons with a substance use disorder and no history of psychosis (n=14). Analyses revealed that both psychosis cohorts scored lower than controls on the MAS-A total and all subscales except metacognitive mastery. Compared to the FEP group, the persons with prolonged psychosis demonstrated greater metacognitive capacities only in those MAS-A domains reflective of the ability to understand the mental state of others and to see that others may have motivations and desires separate from their own. Other domains of metacognition did not differ between psychosis groups. The Eyes, Hinting and BLERT scores of the two psychosis groups did not differ but were poorer than those produced by the control group. Exploratory correlations in the FEP group showed a pattern similar to that previously observed in prolonged psychosis. Taken together, these findings suggest that while certain domains of metacognition could improve with prolonged psychosis, difficulties with global metacognition and social cognition may be stable features of the disorder and perhaps unique to psychosis.

KEYWORDS:

FEP; First episode psychosis; Metacognition; Prolonged psychosis; Social cognition; Symptoms

PMID:
24503175
DOI:
10.1016/j.schres.2014.01.012
[Indexed for MEDLINE]

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