title: Metacognition in psychosis: comparison of schizophrenia with bipolar disorder.
abstract: While deficits in metacognition have been observed in schizophrenia (SZ), it is less clear whether these are specific to the disorder. Accordingly, this study compared metacognitive abilities of patients with schizophrenia and bipolar disorder (BD) and examined the degree to which neurocognition contributed to metacognitive deficits in both groups. Participants were 30 patients with SZ and 30 with BD. Metacognitive capacity was measured using the Metacognition Assessment Scale Abbreviated (MAS-A). This scale comprises four domains: self-reflectivity, understanding others' minds, decentration and mastery. Verbal memory, executive functioning and symptoms were concurrently assessed. Group comparisons revealed that SZ patients had greater deficits in metacognitive self-reflectivity, which correctly classified 85.2% of patients with SZ in a logistic regression. Self-reflectivity and understanding others'minds were related to verbal memory and executive functioning in the SZ group, but not in the BD group. Furthermore, greater positive and general psychotic symptoms were associated with poorer metacognition in SZ. Results suggest SZ involves unique deficits in the ability to self-reflect and that these deficits may be uniquely linked with neurocognition.
authors.affiliation: Department of Psychology, Uskudar University, Istanbul, Turkey; LWL University Hospital, Division of Cognitive Neuropsychiatry and Psychiatric Preventative Medicine, Ruhr University Bochum, NRW, Germany. Electronic address: cumhur.tas@uskudar.edu.tr.
authors.forename: Cumhur
authors.initials: C
authors.lastname: Tas
authors.affiliation: LWL University Hospital, Division of Cognitive Neuropsychiatry and Psychiatric Preventative Medicine, Ruhr University Bochum, NRW, Germany; Maryland Psychiatric Research Centre, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Elliot C
authors.initials: EC
authors.lastname: Brown
authors.affiliation: Department of Psychiatry, Celal Bayar University, Manisa, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Aydemir
authors.affiliation: LWL University Hospital, Division of Cognitive Neuropsychiatry and Psychiatric Preventative Medicine, Ruhr University Bochum, NRW, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Brüne
authors.affiliation: Roudebush VA Medical Center, Indianapolis, IN, USA; Indiana University School of Medicine, USA.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Lysaker
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000150:complications*; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000209:etiology* / Q000523:psychology; D032882:Comprehension; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008568:Memory; D008875:Middle Aged; D011618:Psychotic Disorders / Q000523:psychology; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology; D014706:Verbal Learning
keywords: Bipolar disorder; Metacognition; Neurocognition; Schizophrenia