Are there sensory perception differences identified in first-episode psychosis patients compared to others?
Sensory perception differences have been identified in people with first-episode psychosis (FEP) compared to healthy individuals. These differences involve how the brain processes sights, sounds, and smells. Research shows that FEP patients may perceive objects as larger than they are, experience more discomfort from sounds, and have trouble identifying smells. These sensory changes are not just symptoms but may also help predict outcomes and guide early treatment.
What the research says
A 2024 observational study found that FEP patients circled larger perceived sizes on a picture test compared to healthy controls, with a very large effect size (d=2.86, p<0.0001) 1. The same study reported that FEP patients experienced higher levels of auditory discomfort than controls (d=1.46, p<0.0003) 1. These sensory alterations were specific to FEP and schizophrenia, as bipolar disorder patients did not show the same size perception difference 1.
Olfactory identification, or the ability to name smells, is also affected. A 2024 study showed that drug-naïve first-episode schizophrenia patients and ultra-high-risk individuals had significant deficits in olfactory identification compared to healthy controls 8. Earlier research found that 38% of first-episode psychosis patients had olfactory identification deficits (microsmia), and those with deficits had poorer functional outcomes after six months of treatment 9.
Other sensory and brain changes have been observed. A study on antipsychotic-naïve individuals at clinical high risk for psychosis found altered relationships between brain glutamate levels and functional connectivity in regions involved in emotion and reward, suggesting early sensory processing disruptions 5. While not directly about sensory perception, a systematic review noted immune markers like IL-1β and TNF-α are elevated in FEP and linked to negative symptoms, which may indirectly affect sensory experience 4.
What to ask your doctor
- Could sensory tests, like smell identification or size perception tasks, help monitor my or my loved one's early psychosis symptoms?
- Are there any treatments or therapies that address sensory perception difficulties in first-episode psychosis?
- How do sensory changes relate to other symptoms like hallucinations or negative symptoms?
- Should I be concerned if I notice changes in how I perceive sounds, sights, or smells?
- Can sensory testing help predict long-term outcomes or guide treatment decisions?
This question is drawn from common patient questions about Psychiatry and answered using cited medical research. We do not provide individualized advice.