title: Unrealistic self-overconfidence in schizophrenia is associated with left presubiculum atrophy and impaired episodic memory.
abstract: The study aimed at investigating the role of the hippocampal subfields in cognitive insight and the clinical and neuropsychological underpinnings of the related two sub-dimensions, Self-Reflectiveness (SR), i.e., openness to external feedback, and Self-Certainty (SC), i.e., unrealistic overconfidence in one's opinions. In order to do this, 45 patients with a diagnosis of schizophrenia and 45 age- and gender-matched healthy control subjects (HC) were administered the Beck Cognitive Insight Scale (BCIS), along with neuropsychological, clinical and psychopathological assessment, and underwent an MRI investigation. Hippocampal segmentation was carried out. Regression analyses were performed for BCIS indexes, volumetric parameters of hippocampal subfields and clinical and neuropsychological variables. Results highlighted that in the schizophrenia group, higher levels of SC were related to reduced volume of the left presubiculum, and worse episodic memory. No significant relationship emerged for the SR index. There was no significant relationship between any of the BCIS indexes and volumetric data of the hippocampal subfields in the HC group. Our data support the hypothesis that unrealistic self-overconfidence in schizophrenia is related to the hippocampal presubiculum atrophy, which is involved in episodic memory and cognitive control and is supposed to be underpinned by difficulty in integrating new memories and thus in generating new hypotheses about the self.
authors.affiliation: Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy. Electronic address: md.orfei@hsantalucia.it.
authors.forename: Maria Donata
authors.initials: MD
authors.lastname: Orfei
authors.affiliation: Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy; Museo storico della fisica e Centro studi e ricerche Enrico Fermi, Rome, Italy. Electronic address: f.piras@hsantalucia.it.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Piras
authors.affiliation: Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy. Electronic address: n.banaj@hsantalucia.it.
authors.forename: Nerisa
authors.initials: N
authors.lastname: Banaj
authors.affiliation: Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy; Psychiatry and Clinical Psychology Unit, Department of Neurosciences, Fondazione Policlinico "Tor Vergata", Rome, Italy. Electronic address: di.lorenzo@med.uniroma2.it.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Di Lorenzo
authors.affiliation: Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy; Psychiatry and Clinical Psychology Unit, Department of Neurosciences, Fondazione Policlinico "Tor Vergata", Rome, Italy. Electronic address: siracusano@med.uniroma2.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Siracusano
authors.affiliation: Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy. Electronic address: c.caltagirone@hsantalucia.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Caltagirone
authors.affiliation: Department of Mental Health, ASL Roma 1, Rome, Italy. Electronic address: pierluca.bandinelli@aslroma1.it.
authors.forename: Pier Luca
authors.initials: PL
authors.lastname: Bandinelli
authors.affiliation: Department of Mental Health, ASL Roma 1, Rome, Italy. Electronic address: giuseppe.ducci@aslroma1.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ducci
authors.affiliation: Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy; Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA. Electronic address: g.spalletta@hsantalucia.it.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Spalletta
mesh_terms: D000328:Adult; D001284:Atrophy / Q000000981:diagnostic imaging / Q000473:pathology / Q000523:psychology; D003071:Cognition; D005260:Female; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000000981:diagnostic imaging / Q000473:pathology* / Q000523:psychology; D061212:Memory, Episodic; D008875:Middle Aged; D009483:Neuropsychological Tests; D011594:Psychometrics; D012559:Schizophrenia / Q000000981:diagnostic imaging / Q000473:pathology*; D012565:Schizophrenic Psychology; D012649:Self Concept
keywords: Cognitive insight; Hippocampus; Schizophrenia; Self-Certainty; Self-Reflectiveness