Self-Awareness of Psychopathology and Brain Volume in Patients With First Episode Psychosis

Abstract

Memory impairment, excessive rumination, and increased interpersonal sensitivity are major characteristics of high psychosis risk or first episode psychosis (FEP). Herein, we investigated the relationship between brain volume and self-awareness of psychopathology in patients with FEP. All participants (FEP: 34 and HCs: 34) completed clinical assessments and the following self-reported psychopathology evaluations: prospective and retrospective memory questionnaire (PRMQ), ruminative response scale (RRS), and interpersonal sensitivity measure (IPSM). Structural magnetic resonance imaging was then conducted. The PRMQ, RRS, and IPSM scores were significantly higher in the FEP group than in the healthy controls (HCs). The volumes of the amygdala, hippocampus, and superior temporal gyrus (STG) were significantly lower in the FEP group than in the HCs. There was a significant group-dependent moderation effect between self-awareness of psychopathology (PRMQ, RRS, and IPSM scores) and right STG (rSTG) volume. In the FEP group, self-awareness of psychopathology was positively associated with rSTG volume, while in the HCs, this correlation was negative. Our results indicate that self-awareness of psychopathology impacts rSTG volume in the opposite direction between patients with FEP and HCs. In patients with FEP, awareness of impairment may induce increases in rSTG brain volume. However, HCs showed decreased rSTG volume when they were aware of impairment.

Keywords: interpersonal sensitivity measure; prospective and retrospective memory questionnaire; right superior temporal gyrus; ruminative response scale; schizophrenia.

Figure 1

(A) Moderation of the effect of self-reported psychopathology evaluations (prospective and retrospective memory questionnaire (PRMQ), ruminative response scale (RRS), and interpersonal sensitivity measure (IPSM)) on right superior temporal gyrus (rSTG) volume at values of the moderator group. (B) rSTG region (red colored).

Figure 2

Significant group dependent moderation effect between self-reported psychopathology evaluations (prospective and retrospective memory questionnaire (PRMQ), ruminative response scale (RRS), and interpersonal sensitivity measure (IPSM)) and right superior temporal gyrus (rSTG) volume. In first episode psychosis (FEP) group, the PRMQ score significantly positively correlated with the rSTG volume, also RRS and IPSM, positively correlated with the rSTG volume. In healthy control (HC) group, the PRMQ, RRS, and IPSM scores significantly negatively correlated with the rSTG volume.