Behavioral evidence of impaired self-referential processing in patients with affective disorders and first-episode schizophrenia

Sci Rep. 2024 May 10;14(1):10754. doi: 10.1038/s41598-024-60498-5.

Abstract

Despite the critical role of self-disturbance in psychiatric diagnosis and treatment, its diverse behavioral manifestations remain poorly understood. This investigation aimed to elucidate unique patterns of self-referential processing in affective disorders and first-episode schizophrenia. A total of 156 participants (41 first-episode schizophrenia [SZ], 33 bipolar disorder [BD], 44 major depressive disorder [MDD], and 38 healthy controls [HC]) engaged in a self-referential effect (SRE) task, assessing trait adjectives for self-descriptiveness, applicability to mother, or others, followed by an unexpected recognition test. All groups displayed preferential self- and mother-referential processing with no significant differences in recognition scores. However, MDD patients showed significantly enhanced self-referential recognition scores and increased bias compared to HC, first-episode SZ, and BD. The present study provides empirical evidence for increased self-focus in MDD and demonstrates that first-episode SZ and BD patients maintain intact self-referential processing abilities. These findings refine our understanding of self-referential processing impairments across psychiatric conditions, suggesting that it could serve as a supplementary measure for assessing treatment response in first-episode SZ and potentially function as a discriminative diagnostic criterion between MDD and BD.

Keywords: Bipolar disorder; Major depressive disorder; Mother-referential processing; Schizophrenia; Self-reference effect; Self-referential processing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bipolar Disorder* / physiopathology
  • Bipolar Disorder* / psychology
  • Case-Control Studies
  • Depressive Disorder, Major* / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Schizophrenia* / physiopathology
  • Schizophrenic Psychology*
  • Self Concept*
  • Young Adult