title: Metacognition in first-episode psychosis and its association with positive and negative symptom profiles.
abstract: There is growing evidence that metacognitive abilities which include the ability to synthesize knowledge regarding mental states in self and others and use this ability to solve problems are impaired in non-affective psychosis and associated with positive and negative symptom severity. We sought to (a) investigate the severity of metacognitive impairments in first-episode psychosis (FEP) compared to non-clinical controls and (b) explore associations with positive and negative symptom profiles. Ninety-seven people with FEP were compared to 101 control persons. Metacognition was assessed with interviews and the Metacognitive assessment scale-abbreviated. Four groups based on positive and negative symptoms were identified by cluster analysis and compared on metacognition, childhood adversities, duration of untreated psychosis and premorbid social and academic adjustment. Those with high levels of negative symptoms had poorer metacognitive abilities. Those with high positive and low negative symptoms did not have poorer metacognitive abilities than those with low positive and negative symptoms. None of the other predictors differed between the groups. The FEP group had poorer metacognitive abilities than the control group. Inclusion of metacognition in psychosis models may improve our understanding of negative symptoms, while previous findings of a relation with positive symptoms may have been confounded. Implications for current interventions are discussed.
authors.affiliation: Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Psychiatric Research Unit, Region Zealand Psychiatry Roskilde, Roskilde, Denmark; Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, Roskilde, Denmark. Electronic address: marietrauelsen@gmail.com.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Trauelsen
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Gumley
authors.affiliation: Psychiatric Research Unit, Region Zealand Psychiatry Roskilde, Roskilde, Denmark; Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, Roskilde, Denmark.
authors.forename: Jens Einar
authors.initials: JE
authors.lastname: Jansen
authors.affiliation: Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, Roskilde, Denmark.
authors.forename: Marlene Buch
authors.initials: MB
authors.lastname: Pedersen
authors.affiliation: Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, Roskilde, Denmark.
authors.forename: Hanne-Grethe Lyse
authors.initials: HL
authors.lastname: Nielsen
authors.affiliation: Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Christopher Høier
authors.initials: CH
authors.lastname: Trier
authors.affiliation: Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, Roskilde, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Ulrik H
authors.initials: UH
authors.lastname: Haahr
authors.affiliation: Psychiatric Research Unit, Region Zealand Psychiatry Roskilde, Roskilde, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Erik
authors.initials: E
authors.lastname: Simonsen
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D008297:Male; D000067489:Metacognition; D011618:Psychotic Disorders / Q000523:psychology*; D063189:Symptom Assessment / Q000523:psychology*; D055815:Young Adult
keywords: Case-control; Mentalizing; Negative symptoms; Risk; Self-reflectivity; positive symptoms