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

• Published in: Scientific reports Vol. 14; no. 1; p. 10754
• Main Authors: Zhao, Yanli, Xu, Jiahua, Hong, Jiangyue, Xu, Xuejing, Fan, Hongzhen, Zhang, Jinguo, Li, Dong, Chen, Jingxu, Wu, Yaxue, Li, Yanli, Tan, Yunlong, Tan, Shuping
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 10.05.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 631/378/2645; 631/378/2649; 631/477/2811; 692/699/476/1333; 692/699/476/1414; 692/699/476/1799; Adult; Affective disorders; Bipolar disorder; Bipolar Disorder - physiopathology; Bipolar Disorder - psychology; Case-Control Studies; Depressive Disorder, Major - psychology; Female; Humanities and Social Sciences; Humans; Major depressive disorder; Male; Mental depression; Mental disorders; Middle Aged; Mother-referential processing; multidisciplinary; Schizophrenia; Schizophrenia - physiopathology; Schizophrenic Psychology; Science; Science (multidisciplinary); Self Concept; Self-reference effect; Self-referential processing; Young Adult; Self-referential processing; Schizophrenia; Mother-referential processing; Bipolar disorder; Self-reference effect; Major depressive disorder
• DOI: 10.1038/s41598-024-60498-5
• ISSN: 2045-2322

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.