Clinical, cognitive and neural correlates of self-monitoring deficits in schizophrenia: an update.

BACKGROUND

An area of recent interest in schizophrenia research is to investigate specific neural and cognitive abnormalities associated with symptoms of this disorder.

OBJECTIVE

To establish clinical, cognitive and neural correlates of self-monitoring deficits in schizophrenia, which according to various theoretical models can account for the first-rank symptoms of this disorder.

METHODS

Relevant data were identified from PubMed and PsycInfo searches up to July 2006 using combinations of keywords including 'self-monitoring', 'symptoms', 'self-agency', 'neuropsychological', 'cognitive', 'brain activity', 'PET' and 'fMRI'.

CONCLUSIONS

Self-monitoring deficit is most consistently observed in patients with schizophrenia with auditory hallucinations and passivity experiences. This deficit may not be schizophrenia specific. At present, there are insufficient direct data to reach meaningful conclusions about the cognitive correlates of this deficit. Functional neuroimaging studies in patients with schizophrenia with auditory hallucinations point to defective engagement of the neural regions known to be involved in self-monitoring in healthy people. Further multimodal studies using validated cognitive and clinical measures, self-monitoring paradigms and appropriate imaging tools to analyze patients with schizophrenia with and without self-monitoring deficits are required to increase our understanding of this topic.