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Comment & Response
March 2018

Corollary Discharge and Psychosis—Origin of the Model

Author Affiliations
  • 1Department of Psychiatry and Behavioral Sciences, University of California, Davis
JAMA Psychiatry. 2018;75(3):300-301. doi:10.1001/jamapsychiatry.2017.4012

To the Editor I recognize that an educational review cannot include exhaustive citations. However, I believe that these articles could briefly acknowledge the origin of their major ideas. The review by Poletti et al1 in JAMA Psychiatry on abnormal corollary discharge and psychosis cites only relatively recent articles. The idea that corollary discharge mechanisms exist in the control systems of thought was first proposed in 1978.2 At the levels of consciousness, these mechanisms would distinguish endogenous from environmentally stimulated mental activity. The 1978 article2 outlined the reasoning and evidence pointing to the operation of corollary discharge feed-forward systems at the highest sensory-motor levels (in the conceptualization by John Hughlings Jackson, FRS). It illustrated how impairment of such mechanisms would produce many psychotic symptoms, including auditory hallucinations, thought control, and other confusions of self and agency.