Conditioned blocking in patients with paranoid, non-paranoid psychosis or obsessive compulsive disorder: associations with symptoms, personality and monoamine metabolism

Abstract

Introduction: Conditioned blocking (CB) refers to a delay in learning that a new stimulus, added during learning, has the same consequences as the conditioned stimulus already present. In animals such "learned inattention" depends on monoaminergic and limbic function and, thus, CB performance should be informative on selective information processing impairments found in subgroups of psychotic patients. Attenuated CB in acute schizophrenia has been reported to normalize rapidly. Method: This study examines in young patients the specificity of CB performance to illness, and its associations with symptoms, personality traits and monoaminergic metabolic status. Results: Performance: CB was attenuated in psychotic patients with nonparanoid symptoms (NP: n=12, mean age 17 years) with respect to obsessive compulsive (OCD: n=13, mean age 16 years) and healthy subjects (CON; n=29, mean age 18 years), but only a transient attenuation was observed in paranoid hallucinatory patients (PH: n=14, mean age 19 years). The severity of negative symptoms in psychosis and specific negative/positive symptoms in the NP/PH groups were associated with reduced CB. Outgoing personality traits in CON and OCD subjects correlated with CB. In NP patients attenuated CB was associated with increasing neurotic lability. In PH patients CB correlated positively with "manic" but negatively with psychotic or neurotic scores. Monoamines: Increased dopamine activity (24h urine samples) correlated positively with CB, but relative increases of noradrenaline metabolism in NP and serotonin metabolism in OCD patients interfered. Conclusions: Marked psychotic or neurotic traits and some negative symptom states were associated with reduced CB. The particular selective processing problems of NP patients may reflect inappropriate NA activity.