Abstract
BackgroundJumping to conclusions (JTC) is a well-established reasoning and data gathering bias found in patients with psychosis even at illness onset (First Episode Psychosis, FEP). Preliminary work in this field focused primarily on the association with delusions, although jumping to conclusions has also been found in non-deluded schizophrenia patients after remission, and in individual with at risk mental state.Moreover, psychotic patients tend to show impairments in social cognition, struggling in identifying, processing and interpreting social clues. Deficits in facial emotion recognition (FER) – a key component of the construct – represent a well-replicated finding in schizophrenia. Furthermore, deficits in global facial affect recognition have been found in FEP with the same severity as at further stages, especially for anger recognition. The present study aims to measure JTC and FER bias in a sample of FEP recruited across 5 European countries, compared with healthy controls.MethodsData on JTC (Beads task 60:40), FER (Degraded Facial Recognition task – DFAR) and socio-demographics have been analysed in a sample of 643 FEP and 1019 population controls recruited as part as the EU-GEI study across UK, Netherlands, France, Spain, and Italy.IQ scores were used to exclude cases and controls with current IQ<70 (N=171) from JTC analysis and a score <41 (N=384) on the Benton Facial Recognition test for the analysis on DFAR. Logistic regression model was applied to predict case/control status using 1) JTC and 2) DFAR as predictive variables controlling for age, gender and country.ResultsWe showed that the presence of JTC bias varies across different countries both in cases (χ2=23.77 p<0.001) and controls groups (χ2=14.01 p=0.007).Logistic regression analyses revealed JTC to be a significant predictor of case/control status (Adj OR=1.88 CI 95%=1.43–2.29 p<0.001).As well as JTC, FER differed over Europe in both groups (FEP, total: F=17.37, p<0.001; neutral: F=12.4, p<0.001; happy: F=25.62, p<0.001; frightened: F=8.78, p<0.001; angry: F=5.48, p<0.001. Controls, total: F=23.06, p<0.001; neutral: F=21.72, p<0.001; happy: F=21.74, p<0.001; frightened: F=14.14, p<0.001; angry: F=12.49, p<0.001).Logistic regression analyses revealed all DFAR scores, except for happy emotions, to be negatively associated with case/control status (total: B=-.0182 p=0.001; neutral: B=-.054 p=0.003; happy: B=-.0196 p=0.2; frightened: B= -.065 p<0.001; angry: B=-.030 p=0.04).DiscussionThis study supports the evidence that 1) FEP patients are more likely to present JTC and FER impairments than controls; 2) cognition and social cognition might represent transcultural features of psychotic disorders.
Highlights
Motivational deficits are prevalent feature of schizophrenia, which have been tightly linked to real-world outcomes
Logistic regression model was applied to predict case/control status using 1) JTC and 2) DFAR as predictive variables controlling for age, gender and country
Schizophrenia is associated with deficits in both episodic and semantic memory our understanding of how the deficits in each system independently contribute to overall memory performance is poorly understood
Summary
Neurocognitive deficits are associated with many serious mental illnesses (SMI), including schizophrenia, bipolar disorder, and major depressive disorder, and have been found to negatively impact social and occupational outcomes, clinical prognosis, and overall quality of life. These deficits have been observed in people in earlier phases of schizophrenia, in young people at clinical high risk (CHR) of psychosis. In these youth, neurocognitive deficits present at a level intermediate to healthy controls and those with early psychosis, indicating that mild impairments in neurocognitive functioning may be early markers of illness development. It was hypothesized that participants in the later stages of risk, characterized by the presence of subthreshold psychiatric symptoms or attenuated syndromes, would exhibit impairments in neurocognitive performance compared to HCs and asymptomatic youth at familial high risk
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