The neurophenomenology of basic self-disturbance in early psychosis: Association with clinical outcome in an ultra-high risk sample

Abstract

Introduction: We previously proposed a neurophenomenological model of schizophrenia, linking basic self-disturbance with neural deficits of source monitoring and aberrant salience. Baseline comparisons in ultra-high risk (UHR) and first-episode psychosis (FEP) samples indicated a relationship between basic self-disturbance and source monitoring deficits, but not aberrant salience. The current paper reports on the 12-month follow-up results in the UHR group (n = 43), focusing on the association between baseline variables and clinical outcomes. Methods: One-way ANOVA compared UHR-remitters (n = 18), UHR-persistent/transitioned to psychosis cases (n = 25) and FEP (n = 38) groups on baseline clinical and neuro-measures. Logistic regression assessed the baseline variables’ predictive power for UHR outcomes. Results: Higher baseline self-disturbance scores (EASE total) were found in the UHR persistence/transition and FEP groups compared to the UHR-remission group, and predicted worse UHR clinical outcomes. Source monitoring deficits were higher in FEP individuals compared to those with UHR persistence/transition. Conclusion: High levels of basic self-disturbance may be a useful predictor marker of poor prognosis in UHR patients.