Self-disorders and the Schizophrenia Spectrum: A Study of 100 First Hospital Admissions

Abstract

Introduction: Self-disorders (SD) have been described as a core feature of schizophrenia both in classical and recent psychopathological literature. However, the specificity of SD for the schizophrenia spectrum disorders has never been demonstrated in a diagnostically heterogeneous sample, nor has the concurrent validity of SD been examined. Aim: (1) To examine the specificity of Examination of Anomalous Self-Experiences (EASE) measured SD to the schizophrenia spectrum disorder in first contact inpatients, (2) to explore the internal consistency and factorial structure of the EASE, (3) to assess the concurrent validity of SD by exploring correlations between SD and the canonical psychopathological dimensions of schizophrenia, (4) to explore relations of SD to intelligence, sociodemographic, and extrinsic illness characteristics. Methods: A total of 100 consecutive first admission patients underwent a comprehensive psychopathological examination and an assessment of SD with the EASE scale. The diagnostic distribution of the EASE scores was tested with ANOVA, whereas the relations between the EASE scores and other symptomatic dimensions of schizophrenia were tested with Spearman’s rho. A potential factorial structure and the internal consistency of the EASE scale were also examined. Results: SD aggregated significantly in the schizophrenia spectrum disorders, with no differences between schizophrenia and schizotypal disorders. EASE scores correlated moderately with canonical psychopathological dimensions of schizophrenia. Factor analysis of the EASE disclosed only one factor and the internal consistency of the EASE was excellent. Conclusions: SD aggregate selectively in the schizophrenia spectrum disorders, with similar levels in schizophrenia and schizotypy. The study lends validity to the view of SD as an experiential vulnerability phenotype of the schizophrenia spectrum disorders.

Premorbid self‐disorders and lifetime diagnosis in the schizophrenia spectrum: a prospective high‐risk study

“…Although our design involved contrastive groups (schizophrenia spectrum vs. no mental illness) and thus did not allow us to assess specificity, these results, in conjunction with other available empirical evidence, 17,39 are not inconsistent with the notion of SDs as a core vulnerability feature in schizophrenia, 11 detectable in both the premorbid and the prodromal stages 17 of schizophrenia. Importantly, SDs are shared by schizophrenia and schizotypal disorders, with no significant differences between these two diagnostic groups.…”

“…10 A series of subsequent systematic empirical studies demonstrated that SDs aggregate selectively in first-admission schizophrenia and schizotypal disorders [11][12][13] but not in bipolar psychosis. 14,15 SDs are detectable in populations at high-genetic risk for schizophrenia 13 and are associated with prodromal symptoms among help-seeking, non-psychotic adolescents.…”

“…finding a new life meaning) and solipsistic experiences. The EASE exhibits high internal consistency (Cronbach's alpha above 0.80 11,14 ) and a monofactorial structure. 11,27 Although all studies seem to support the notion of SDs as a spectrum-specific manifestation of vulnerability, and follow-up studies of help-seeking, prodromal and first-admission patients have shown the utility of SDs for predicting later spectrum disturbance, 17,18 there have been as yet no attempts to identify SDs and gauge their predictive value in a premorbid, not-help-seeking population at high risk for schizophrenia.…”

Cenesthopathy in adolescence: An appraisal of diagnostic overlaps along the anxiety–hypochondriasis–psychosis spectrum

“…an increasing disruption between subjectivity and bodily experience where the schizophrenic person behaves like a soulless body, leading to initially normal cenestheasias being lived in hyperreflexive awareness and diminished self-awareness [37]. In studies using a scale for the phenomenological Examination of Anomalous Self-Experience (EASE) [38] that include cenesthetic experiences overlapping with Huber"s cenesthopathies, self-disorders were more prevalent in adolescents meeting at-risk criteria for psychosis than in their non-psychotic helpseeking peers [39] and aggregated selectively in the schizophrenia spectrum [40]; however, prevalence of cenesthetic experiences was not reported specifically. The phenomenological view warrants that abnormal bodily experiences should be included as diagnostic hallmarks for schizophrenia [37].…”

Self-disorders: A promising Candidate for Early Detection

“…SDs are non-psychotic experiential phenomena. During the last two decades, an accumulating amount of empirical studies have shown that SDs constitute a specific experiential vulnerability phenotype of the schizophrenia spectrum (9,10). The idea that SDs form core features of schizophrenia is not new; explicit references to a variety of abnormal selfexperiences can be found in nearly all of the foundational texts that address schizophrenia (e.g., Kraepelin, Bleuler, Jaspers, Berze, Minkowski, Schneider).…”