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European Archives of Psychiatry and Clinical Neuroscience
Published in: European Archives of Psychiatry and Clinical Neuroscience 4/2021

01-06-2021 | Schizophrenia | Original paper

Altered risky decision making in patients with early non-affective psychosis

Authors: Luk MSK, Chang WC, Chong CSY, Siu CMW, Chan SKW, Lee EMH, Hui CLM, Sun YN, Lee TMC, Lo TL, Chen EYH

Published in: European Archives of Psychiatry and Clinical Neuroscience | Issue 4/2021

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Abstract

Abnormal risky decision making may represent an important factor contributing to functional impairment in psychotic disorders. Previous research revealed impaired decision making under risk in patients with chronic schizophrenia. However, risky decision making is under-studied in the early course of illness. We examined risky decision making in 33 patients with early non-affective psychosis and 32 demographically matched controls, using two well-validated experimental paradigms, balloon analogue risk task (BART) and Risky–Gains task (RGT), which modeled and assessed actual risk-taking behaviors in deliberative and time-pressured decision-making situations, respectively. Our results showed that patients exhibited suboptimal decision making on the BART and were more risk averse than controls by having fewer average balloon pumps in non-burst trials, lower explosion rate and lower total points gained. On the RGT, patients also behaved more conservatively than controls, with lower overall rate in choosing the risky option. Intriguingly, patients performed comparably to controls in adjusting risk-taking pattern following punished trials, suggesting relatively preserved sensitivity to punishment in early psychosis. Risk-taking measures showed no significant correlations with any symptom dimensions, impulsivity traits, cognitive functions or antipsychotic treatment after correcting for multiple comparisons. This study is the first to investigate risk-taking propensity in early psychosis based on BART/RGT performance, and consistently indicate that patients with early psychosis displayed altered risky decision making with increased risk aversion relative to healthy participants. Further investigation is warranted to clarify the longitudinal course of aberrant risky decision making and its relationship with functional outcome in early psychosis.
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Metadata
Title
Altered risky decision making in patients with early non-affective psychosis
Authors
Luk MSK
Chang WC
Chong CSY
Siu CMW
Chan SKW
Lee EMH
Hui CLM
Sun YN
Lee TMC
Lo TL
Chen EYH
Publication date
01-06-2021
Publisher
Springer Berlin Heidelberg
Keyword
Schizophrenia
Published in
European Archives of Psychiatry and Clinical Neuroscience / Issue 4/2021
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI
https://doi.org/10.1007/s00406-019-00994-2

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