| Objective Schizophrenia is among the most complex and devastating forms of mental illness,Most researchs have stressed that the dysfunction found in this condition results from an array of symptoms, neurocognitive deficits and associated social factors such as trauma, poverty and stigma. More recent work, however, has stressed that deficits in metacognition also play a role in outcome.metacognition refers to a range meanings including broader processes in which information is integrated in more or less effective ways into complex representations of the self and others. In this paper,we hypothesised that patients with shizophrenia suffer meatcognition deficit which is related with psychotic symptom and social-cognition,like,empathy and theory of mind.The aim of this study is to explore the relationship among the metacogtive ability, psychotic symtoms socia-cognition in schizophrenic patients.Methods In study one, seventy-seven schizophrenic patients in a post-acute phase of illness and thirty-four patients with neuroses were assessed with the abbreviated metacognition assessment scale(MAS-A) and the interpersonal reactivity index-C(IRI-C),and eighty-six normal subjects were rated with the IRI-C. Additionally, psychotic symptoms of the schizophrenic patients were assessed with the positive and negative syndrome scale( PANSS). In study two, S eventy schizophrenic patients in post-acute phase of illness and fifty patients with anxiety disorder were assessed with the Abbreviated Metacognition Assessment Scale(MAS-A) in order to measured their ability of metacognition, then the two groups of patients and fifty-five normal people were assessed with Theory of Mind Picture Sequencing Task(To M-PST).Themetacognitve function of patients with schizophrenia was compared with that of patients with anxiety disorder. Correlation between metacognition ability and theory of mind in patients with schizophrenia was analyed using Spearman correlation anlysis.Results In study one, the MAS-A total score, the subscores in self-reflectivity, understanding of other’, decentration, mastery of MAS-A [respectively(8.8±3.3),(3.4±1.1),(2.5±1.0),(0.4±0.6),(2.4±1.1)] were significantly lower i n the schizophrenic patients group than those in the neuroese patients group [respectively(12.7±3.4),(4.5±1.2),(3.3±0.9),(1.1±0.7),(3.3±1.2)](P<0.01).Correlation analysis showed that the MAS-A scores were significantly negatively correalated with the PANSS scores(r=0.248~0.491,P<0.05), and the MAS-A scores had significantly positively correlation with the IRI-C scores(r=0.229~0.305, P<0.05),the relationship were persisted when the scores of PANSS were statistically controled. In study two, T he MAS-A total score, the subscores of self-reflectivity, understanding the other s’ mind,decentration and mastery [respectively(8.91±3.45),(3.46±1.11),(2.50±1.09),(0.46±0.57),(2.49±1.19)] were significantly lower i n the patients with schizophrenia than those in the patients with anxiety disorder [respectively(12.72±3.27),(4.79±1.16),(3.28±0.95),(1.09±0.70),(3.56±1.08)](Z=-3.858~-5.309,P<0.01). Compared with the normal people, patients with schizophrenia and anxiety disorder had significantly lower total scores in To M-PST [(47.30±9.19)vs(58.29±1.06);(55.58±5.02)vs(58.29±1.06)](Z=-8.344,-2.084;P<0.05). Correlation analysis showed a positive correlation between the total score of MAS-A and that of To M-PST(r=0.460,P<0.01) in the patients with schizophrenia, and the correlation was persisted when the PANSS total score and ill-ness duration were statistically controled(r=0.418,P<0.01).The total score of MAS-A of patients with schizophrenia was negatively correlated with the total score of PANSS(r=-0.547,P<0.01) and the subscores of negative symptoms(r=-0.518, P<0.01) and positive symptoms(r=-0.348, P<0.01).Conclution In study one, schizophrenic patients suffer the metacognitive ability defecit which was correlated with impaired empathy and psychotic symtoms. In study two, Patients with schizophrenia experienced metacognitive deficits which were related to the impairements of theory of mind, this may suggest that they shared the same neurophysiological basis. |
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