Anomalous self-experiences are central to schizophrenia and other psychiatric disorders. This analysis compared such experiences in schizophrenia-spectrum disorders, as cataloged in the EASE, with those described in severe depersonalization. Numerous affinities were found, showing that pure forms of diminished self-affection (depersonalization) can involve experiences resembling those of schizophrenia. However, important discrepancies emerged, suggesting that more automatic or deficiency-like factors—probably involving self/world or self/other confusion and erosion of first-person perspective—are more distinctive of schizophrenia-spectrum disorders.
People in the early stages of psychosis show a reduced ability to accurately evaluate their own perceptions, a metacognitive deficit. In a perceptual decision-making task, individuals with first-episode psychosis performed worse on metacognitive accuracy than healthy controls, even when their basic perceptual performance was accounted for. Grey matter volume was also reduced in the superior frontal gyrus, a brain region linked to metacognition. However, no direct relationship was found between grey matter volume and metacognitive accuracy, leaving the neural basis of this deficit unclear. These findings suggest that a specific problem in scrutinizing one's own perceptions may underlie later functional difficulties in schizophrenia.