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Aims: Improving diagnostic batteries to identify individuals at‐risk for developing psychotic disorders as early as possible is an ongoing challenge in schizophrenia research. Here, we sought to explore whether metacognition in at‐risk of developing psychosis would differ from that of first episode psychosis and unaffected controls and whether dysfunctional metacognitive beliefs would be associated with psychosocial functioning in the clinical groups. Methods: Twenty‐three subjects at‐risk of psychosis were compared with a group of 15 first psychotic episode patients and 21 healthy controls with regard to their metacognitive beliefs and psychosocial functioning. Metacognition was assessed using the Metacognition Questionnaire (MCQ), psychosocial functioning was rated using the Personal and Social Performance Scale (PSP). Depression and anxiety were also evaluated. Results: The clinical groups differed significantly from controls in several MCQ scores, particularly the subscales "negative beliefs" and "need for control," as well as on all PSP scales. Furthermore, significant correlations emerged between the metacognition and psychosocial functioning. A mediation analysis revealed that dysfunctional metacognitive beliefs had no direct effect on psychosocial functioning, but was mediated by depressive symptoms. Conclusions: These results corroborate findings assigning depressive symptoms an important role in early recognition of psychosis. [ABSTRACT FROM AUTHOR]

Background: The objective of this study is to test the conflicting theories concerning the association of negative self and other schemata and paranoid ideation. Methods: A risk‐based approach, including risk stratification, is used to gain insight into the association of the negative self and other schemata that may be shared by individuals or differentiate between individuals at clinical high risk (CHR) for a first‐episode psychosis and those with full‐blown psychosis. The dataset includes a sample of individuals at CHR (n = 137) and a sample of individuals with persisting positive symptoms (PPS, n = 211). The CHR sample was subdivided according to a prognostic index yielding 4 CHR sub‐classes with increasing risk for transition to psychosis. Results: Negative beliefs about the self were associated with paranoid ideation in CHR and a lower risk state. In the highest risk state and full‐blown psychosis, there is an association with negative beliefs about others. Conclusion: These findings are in line with theories suggesting a switch from a predominantly activated negative self‐schema to a malevolent others‐schema in association with paranoid ideation along the risk‐continuum. However, due to methodological limitations these results should be replicated by future studies. [ABSTRACT FROM AUTHOR]

Aim Schizophrenia is a heterogeneous disorder that presents differently in men and women: men show a higher propensity to negative symptoms, lower social functioning, earlier age at onset and co-morbid substance abuse, whereas women display more affective symptoms. It is unknown whether these differences extend to subjects at high risk ( HR) of psychosis. Thus, the aim of the present study was to address this question. Methods Clinical symptoms and functioning were assessed using structured interviews in 239 HR subjects (female, n = 80). The definition of being at HR was based on the criteria used in the European Prediction of Psychosis Study ( EPOS). Results Men displayed more pronounced negative symptoms, higher rates of past substance abuse disorders and higher deficits in social functioning. No gender difference was found for depression, which affected almost 50% of the cohort, or age at onset for the fulfilment of HR criteria. Conclusion The higher impairment in specific symptoms observed in male schizophrenia patients was also present in subjects at HR for psychosis. Further studies are required to determine whether these symptoms are gender-specific predictors of transition to psychosis and whether they warrant gender-specific interventions. The high propensity to depression in the present cohort, which was particularly pronounced in the male cohort compared with the general population, in conjunction with the observed increase in negative symptoms and functional impairment, should alert clinicians to the necessity for the identification and treatment of HR subjects, irrespective of the degree to which these features are associated with transition risk. [ABSTRACT FROM AUTHOR]