Looking at the schizophrenia spectrum through the prism of self-disorders: an empirical study

Schizophr Bull. 2011 Mar;37(2):344-51. doi: 10.1093/schbul/sbp056. Epub 2009 Jun 15.

Abstract

Nonpsychotic anomalies of subjective experience were emphasized in both classic literature and phenomenological psychiatry as essential clinical features of schizophrenia. However, only in recent years, their topicality with respect to the construct validity of the concept of the schizophrenia spectrum has been explicitly acknowledged, mainly as a consequence of the increasing focus on early detection and prevention of psychosis. The current study tested the hypothesis of a specific aggregation of self-disorders (SDs, various anomalies of self-awareness) in schizophrenia-spectrum conditions, comparing different diagnostic groups; 305 subjects, previously assessed in the Copenhagen Schizophrenia Linkage Study, were grouped into 4 experimental samples, according to their Diagnostic and Statistical Manual of Mental Disorders (Third Edition Revised) main diagnosis: schizophrenia, (n = 29), schizotypal personality disorder (n = 61), other mental illness not belonging to the schizophrenia spectrum (n = 112), and no mental illness (n = 103). The effect of diagnostic grouping on the level of SDs was explored via general linear model and logistic regression. The diagnosis of schizophrenia and schizotypy predicted higher levels of SDs, and SDs scores were significantly different between spectrum and nonspectrum samples; the likelihood of experiencing SDs increased as well with the diagnostic severity. The findings support the assumption that SDs are a discriminant psychopathological feature of the schizophrenia spectrum and suggest their incorporation to strengthen its construct validity, with potential benefit for both early detection and pathogenetic research.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Diagnostic and Statistical Manual of Mental Disorders
  • Ego*
  • Female
  • Humans
  • Interview, Psychological
  • Linear Models
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / genetics
  • Mental Disorders / psychology
  • Middle Aged
  • Phenotype
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Psychometrics / statistics & numerical data
  • Schizophrenia / diagnosis*
  • Schizophrenia / genetics
  • Schizophrenic Psychology*
  • Schizotypal Personality Disorder / diagnosis*
  • Schizotypal Personality Disorder / genetics
  • Schizotypal Personality Disorder / psychology