Impaired decision making in schizophrenia and orbitofrontal cortex lesion patients.
BACKGROUND
The aim of this study was to examine impaired decision making in patients with schizophrenia and in patients with orbitofrontal cortex lesions.


METHODS
Schizophrenia patients (N=21), healthy controls (N=20) and an independent group of orbitofrontal patients (N=10) underwent a computerized version of the "Regret Gambling Task". Participants chose between two gambles, each having different probabilities and different expected monetary outcomes, and rated their emotional states after seeing the obtained outcome. Regret was induced by providing information about the outcome of the unchosen gamble.


RESULTS
Healthy controls reported emotional responses consistent with counterfactual reasoning between obtained and unobtained outcomes; they chose minimizing future regret and were able to learn from their emotional experience. In contrast, orbitofrontal patients and schizophrenia patients with prominent positive symptoms did not report any regret and did not anticipate any negative consequences of their choices. Our results demonstrate first the presence of very different behavioural deficits within the spectrum of schizophrenia patients which may have contributed to the discrepancies observed in previous studies. Second, the results suggest that a subgroup of schizophrenia patients might have an orbitofrontal dysfunction, in fact, schizophrenia patients with positive symptoms have a behavioural dysfunction analogous to that of the orbitofrontal patients.


CONCLUSIONS
Schizophrenia patients with prominent positive symptoms were unable to integrate cognitive and emotional components of decision making which may contribute to their inability to generate adaptive behaviours in social and individual environments.
Larquet
Marion
M
Rouen University Hospital, INSERM U 614, Faculty of Medicine, 76031 Rouen, France.
Coricelli
Giorgio
G
Opolczynski
Gaëlle
G
Thibaut
Florence
F
D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications* / Q000473:pathology*; D003072:Cognition Disorders / Q000209:etiology*; D003657:Decision Making / Q000502:physiology*; D004644:Emotions / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D005715:Gambling; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011930:Reaction Time; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology; D012938:Social Perception; D013223:Statistics as Topic; D055815:Young Adult