Temporal precision and accuracy in clinically stable patients with schizophrenia: an exploratory study

Background

Alterations in time perception have long been described in schizophrenia, yet the nature of these disturbances remains unclear. While some studies suggest increased variability in temporal processing, findings across tasks and patient populations remain inconsistent [1,2]. In particular, relatively few studies have examined temporal accuracy and precision within the same experimental framework, and evidence from clinically stable outpatient samples remains limited. In addition, the potential influence of antipsychotic treatment on timing performance is still not well understood, despite its potential relevance for interpreting behavioral findings.

Aims

The present study aimed to examine temporal accuracy, trial-to-trial precision, and recalibration dynamics in clinically stable individuals with schizophrenia, using both retrospective and prospective time estimation paradigms.

Methods

Forty-five patients with schizophrenia and forty-four healthy controls matched for age, sex, and education were included. All patients were clinically stable outpatients. Participants completed a retrospective verbal estimation task following the Reading the Mind in the Eyes Test, as well as a prospective time estimation task involving three interval durations (2, 7, and 15 seconds), each presented across three trials. This design allowed the simultaneous assessment of temporal accuracy, variability, and short-term recalibration within the same experimental framework. Temporal accuracy was assessed using relative error, while precision was indexed using the coefficient of variation. Trial-to-trial recalibration was examined using mixed-design ANOVAs. Associations with clinical variables, including symptom severity, illness duration, and antipsychotic medication (chlorpromazine equivalents and medication type), were explored using non-parametric analyses.

Results

Patients showed significantly lower Theory of Mind performance compared to controls (p < 0.001), while no significant group differences were observed in retrospective time estimation. In the prospective task, both groups demonstrated comparable recalibration patterns, with a reduction in estimation error across trials at shorter intervals. No significant group differences were found in temporal accuracy or precision after correction for multiple comparisons. Although coefficient of variation values were numerically higher in patients across all intervals, these differences did not remain statistically significant. No significant associations were identified between timing measures and clinical or medication-related variables, suggesting relative independence of timing performance from symptom severity and treatment-related factors within this sample.

Conclusions

In this sample of clinically stable outpatients with schizophrenia, no robust impairments were observed in temporal accuracy, precision, or recalibration after correction for multiple comparisons. The overall pattern suggests that temporal processing differences, if present, may be subtle and sensitive to methodological factors such as task design, trial structure, and clinical state. These findings are consistent with emerging evidence indicating that variability in temporal precision may be context-dependent rather than uniformly impaired in schizophrenia, particularly in clinically stable populations [3]. Further studies with larger samples, increased trial numbers, and longitudinal designs are needed to clarify the conditions under which timing alterations can be reliably detected.

References

1. Ciullo V. et al. Predictive timing disturbance is a precise marker of schizophrenia. Schizophr Res Cogn. 2018.
2. Thoenes S, Oberfeld D. Meta-analysis of time perception in schizophrenia. Clin Psychol Rev. 2017.
3. Amadeo MB. et al. Time in schizophrenia: a link between psychopathology and psychophysics. Transl Psychiatry. 2022.