Cognitive Identity in Schizophrenia: Vision, Space, and Body Perception from Prodrome to Syndrome

Scientific models of schizophrenia (SZ) lack specificity with regard to progression and etiology of the disease. The aim of this review is to demonstrate that cognitive aberrations associated with impairments of the visual system are disease progression markers from the early SZ prodrome to the chronic, stabilized syndrome. We argue that disrupted oculomotor and visuo-spatial capacities influence higher order cognitive functions that lead to the phenotypic expression of symptoms. A dimensional model is proposed, in which the identified visuo-cognitive aberrations are linked to a subjective cognitive identity deficit, including disease insight and awareness of symptoms. The model provides evidence that etiological explanations of schizophrenia need to take into account anomalous visual information acquisition and processing as dimensional stage markers of the disease. Results are discussed with regards to disease progression, as well as to specific treatment and research targets.