The aim of the proposed research is to test the hypothesis that lack of insight in psychosis is associated with reduced activation of brain circuits subserving self-evaluation and emotion regulation and that this relationship is also dependent on…
ID
Source
Brief title
Condition
- Schizophrenia and other psychotic disorders
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Main study parameters are signal change in bold responses in self-evaluation
and emotion regulation processes in relation to illness insight.
Secondary outcome
Secondary study parameters are behavioural differences between groups in terms
of percentages correct and reaction times regarding the experimental tasks.
Background summary
Lack of insight (unawareness of illness) is a common and clinically relevant
feature of psychosis. The cognitive and neural bases of insight in psychosis
remain unclear, however, rendering it a scientific mystery. This project will
test the hypothesis that lack of insight in psychotic patients is associated
with reduced activation of brain circuits subserving self-evaluation and
emotion regulation. In short, it is presumed that implicit experiential
self-processing is biased towards maintaining a positive self-image (which
excludes mental illness). To obtain insight in psychosis, rational, explicit
self-processing must overrule this automatic response. This will only occur in
the face of sufficient cognitive capacity and motivation. However, a large
number of psychotic patients lack both. Furthermore, a comparison will be made
between patients suffering from affective psychosis versus non-affective
psychosis since in affective psychosis lack of insight seems to be a state
related, whereas in non-affective psychosis lack of insight is thought to be a
trait characteristic. These hypotheses will be tested using methods from
cognitive social psychology and functional neuroscience applying functional
magnetic resonance imaging (fMRI). This would be an innovative research that
elucidates the cognitive and neural bases of self-processing in relation to
poor insight (awareness of illness) in psychosis.
Study objective
The aim of the proposed research is to test the hypothesis that lack of insight
in psychosis is associated with reduced activation of brain circuits subserving
self-evaluation and emotion regulation and that this relationship is also
dependent on whether the nature of the psychosis is affective or non-affective.
Study design
In this study a total of 100 subjects will participate of which 80 subjects
will be patients with a diagnosis of a psychotic disorder. Subjects will be
asked to fill in a total of 7 questionnaires, 5 task outside of the fMRI
scanner, and 3 tasks while lying in the fMRI scanner. Furthermore, 4 interviews
will be conducted in patients, the Young Mania Rating Scale, the Positive And
Negative Symptom Scale, the Schedules for Clinical Assessment in
Neuropsychiatry and the Scale to Assess Insight - Expanded.
Study burden and risks
Subjects will be exposed to a magnetic field of 3 Tesla and rapidly alternating
magnet gradients and radio frequency fields. This field strength is used on a
routinely basis in fMRI and MRI research. So far, no side effects have been
described. On rare occasions, a peripheral nerve (abdomen) is stimulated by the
changing magnet gradients. This will cause an itching feeling, but it is not
harmful.
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Postbus 196
9700 AD Groningen
NL
Postbus 196
9700 AD Groningen
NL
Listed location countries
Age
Inclusion criteria
A total of 40 Patients must have a diagnosis within the schizophrenia spectrum, either schizophrenia or schizophreniform disorder. A total of 40 patients must have a diagnosis within the mood disorders, either bipolar disorder or psychotic depression. All patients must have a history of psychosis as we are interested in insight in psychosis. All subjects must be cooperative, capable of lying still in a scanner for one hour and capable of performing the experimental tasks.
Exclusion criteria
Patients may not use classical antipscychotic medication as it has been shown that this type of medication can influence the activation in the frontal cortices. Furthermore, patients may use a maximum of three Lorazepam equivalents, since they must be alert enough to perform the experimental tasks. Patients must be stable on their current medication and may not have had a change in medication in the week before scanning. In addition, patients may not have the diagnosis schizoaffective disorder as this diagnosis has been controversial, difficult to diagnose and patients who have had this diagnosis are often diagnosed with schizophrenia later in life. All subjects may not have a 'relevant' neurological disorder affecting the Central Nervous System for which they are treated nor may the psychiatric diagnosis have a somatic origin.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL25295.042.08 |