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Illness insight and neurophysiological error-processing deficits in schizophrenia.

Vinay Kansal1, Iulia Patriciu2, Michael Kiang3

  • 1Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8S 4K1, Canada.

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|April 18, 2014
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Schizophrenia patients with poor insight do not show deficits in error monitoring. This study found no link between error-related brain activity and illness insight in schizophrenia, suggesting other factors are involved.

Keywords:
CognitionElectrophysiologyError positivityError processingError-related negativityEvent-related potentialsIllness insightNeurophysiologySchizophrenia

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Cognitive Psychology

Background:

  • Impaired illness insight in schizophrenia correlates with poor treatment adherence and outcomes.
  • Schizophrenia is characterized by deficits in error monitoring, which have been hypothesized to underlie poor insight.

Purpose of the Study:

  • To investigate the association between neurophysiological error-monitoring deficits and impaired illness insight in schizophrenia patients.
  • To determine if error-related negativity (ERN) and error positivity (Pe) event-related potential (ERP) amplitudes are linked to insight levels in schizophrenia.

Main Methods:

  • Electroencephalography (EEG) was used to record event-related potentials (ERPs) during a Stroop task.
  • 18 schizophrenia patients and 18 healthy controls participated.
  • Correlation analyses examined the relationship between ERN/Pe amplitudes and insight measures.

Main Results:

  • Schizophrenia patients exhibited reduced error-related negativity (ERN) and error positivity (Pe) amplitudes compared to controls.
  • These subnormal ERN and Pe amplitudes did not correlate with the level of illness insight in patients.
  • The findings do not support the hypothesis that deficient error monitoring causes impaired insight in schizophrenia.

Conclusions:

  • Impaired illness insight in schizophrenia appears to be independent of deficits in error-monitoring neurophysiology.
  • Alternative neurocognitive mechanisms may be responsible for poor insight in schizophrenia.
  • Further research is needed to identify the specific factors contributing to impaired insight in this population.