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Faux pas recognition performance in a help-seeking population at clinical high risk of psychosis

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Abstract

There is a growing body of evidence suggesting that patients with psychosis show impaired theory of mind (ToM). However, much remains to be understood as to whether ToM deficits occur in the premorbid or post-onset period of psychosis. Our primary aim was to examine empirically impairment on ToM tasks in a group of individuals with clinical high risk (CHR) of psychosis. Fifty CHR participants identified through the Structured Interview for Prodromal Syndromes and 52 age-/education-matched controls were assessed with a complete standard neuropsychological battery (the MCCB, MATRICS Consensus Cognitive Battery) and a social cognition assessment (Faux Pas Test, FPT). We then examined the association of baseline FPT performance with conversion to psychosis at 12-month follow-up. Compared with controls, the CHR group showed significantly poorer performances on the FPT and most MCCB domains. Significant positive correlations were found between faux pas detection and the MCCB domains of Attention/Vigilance and Working Memory in CHR participants when controlling for age and years of education. Mean scores on the FPT in 14 converters who were diagnosed with full-blown psychosis within 12 months were significantly lower than they were for non-converters. Impairments in ToM ability are acquired earlier in the prodromal stage of psychosis, along with general cognition (such as memory function) deficits. Declines in ToM ability may overlap with the progress of psychosis (the gradual loss insight), sharing similar neural substrates, and reflected by impairments in basic cognitive function.

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Acknowledgments

This study was supported by National Natural Science Foundation of China (81201043, 81171267, 81171280, 61102020, 81261120410, 81361120403), Shanghai Municipal Natural Science Foundation (12ZR1448400), Shanghai Science and Technology Committee (15411967200), National Key Clinical Disciplines at Shanghai Mental Health Center (Office of Medical Affairs, Ministry of Health, 2011-873; OMA-MH, 2011-873), Shanghai Clinical Center for Mental Disorders(2014), Shanghai Key Laboratory of Psychotic Disorders (13dz2260500), Doctoral Innovation Fund Projects from Shanghai Jiao Tong University School of Medicine (BXJ 201345), Shanghai Jiao Tong University Foundation (14JCRY04, YG2014MS40), and by a Fogarty and National Institutes of Mental Health Grant (1R21 MH093294-01A1) from the USA.

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Authors and Affiliations

  1. Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, 600 South Wanping Road, Shanghai, 200030, People’s Republic of China

    TianHong Zhang, ZhengHui Yi, HuiRu Cui, YingYing Tang, Xi Lu, LiHua Xu, ZhenYing Qian, YiKang Zhu, LiJuan Jiang, ChunBo Li, KaiDa Jiang, ZePing Xiao & JiJun Wang

  2. Department of Psychology, Florida A&M University, Tallahassee, FL, 32307, USA

    HuiJun Li

  3. Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, 75 Fenwood Rd, Boston, MA, 02115, USA

    HuiJun Li

  4. Department of Psychological Medicine, Changi General Hospital, Singapore, Singapore

    Annabelle Chow

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  1. TianHong Zhang
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Zhang, T., Yi, Z., Li, H. et al. Faux pas recognition performance in a help-seeking population at clinical high risk of psychosis. Eur Arch Psychiatry Clin Neurosci 266, 71–78 (2016). https://doi.org/10.1007/s00406-015-0615-z

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