Impairment of self-monitoring: part of the endophenotypic risk for psychosis.
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.


OBJECTIVE
To investigate (a) whether patients with psychosis show impaired self-monitoring, (b) to what degree this is associated with positive symptoms, and (c) whether this is associated with liability to psychotic symptoms.


METHODS
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
Alterations in 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, whereas in illness failure to recognise alien sources come to the fore.
Department of Psychiatry and Neuropsychology, Maastricht University, PO BOX 616 (VIJV), 6200 MD Maastricht, the Netherlands.
Dagmar
D
Versmissen
Inez
I
Myin-Germeys
Ilse
I
Janssen
Nicolas
N
Franck
Nicolas
N
Georgieff
Joost
J
a Campo
Ron
R
Mengelers
Jim
J
van Os
Lydia
L
Krabbendam
D000293:Adolescent; D000328:Adult; D003702:Delusions / Q000209:etiology; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance; D011618:Psychotic Disorders / Q000503:physiopathology / Q000523:psychology*; D018570:Risk Assessment / Q000379:methods; D012649:Self Concept