Rouy M, Saliou P, Nalborczyk L, Pereira M, Roux P, Faivre N. Systematic review and meta-analysis of metacognitive abilities in individuals with schizophrenia spectrum disorders.
Neurosci Biobehav Rev 2021;
126:329-337. [PMID:
33757817 DOI:
10.1016/j.neubiorev.2021.03.017]
[Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/15/2021] [Accepted: 03/15/2021] [Indexed: 12/22/2022]
Abstract
Metacognitive deficits are well documented in schizophrenia spectrum disorders as a decreased capacity to adjust confidence to performance in a cognitive task. Because metacognitive ability directly depends on task performance, metacognitive deficits might be driven by lower task performance among patients. To test this hypothesis, we conducted a Bayesian meta-analysis of 42 studies comparing metacognitive abilities in 1425 individuals with schizophrenia compared to 1256 matched controls. We found a global metacognitive deficit in schizophrenia (g = -0.57, 95 % CrI [-0.72, -0.43]), which was driven by studies which did not control task performance (g = -0.63, 95 % CrI [-0.78, -0.49]), and inconclusive among controlled-studies (g = -0.23, 95 % CrI [-0.60, 0.16], BF01 = 2.2). No correlation was found between metacognitive deficit and clinical features. We provide evidence that the metacognitive deficit in schizophrenia is inflated due to non-equated task performance. Thus, efforts should be made to develop experimental protocols accounting for lower task performance in schizophrenia.
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