Clinical Manifestations of Self-disorders in Schizophrenia Spectrum Conditions / Number 3 / Volume 18 (2017) / Issues / Current Problems of Psychiatry

Clinical Manifestations of Self-disorders in Schizophrenia Spectrum Conditions

REVIEW PAPER

Curr Probl Psychiatry 2017; 18(3): 177-183

DOI: 10.1515/cpp-2017-0014

© 2017 Medical University of Lublin. This is an open access article distributed under the Creative Commons Attribution-NonComercial-No Derivs licence (http://creativecommons.org/licenses/by-nc-nd/3.0/)

Mads Gram Henriksen^1,2,3, Josef Parnas^1,2,4

¹Mental Health Center Glostrup, University Hospital of Copenhagen

²Center for Subjectivity Research, University of Copenhagen

³Department of Media, Cognition and Communication, Philosophy Section, University of Copenhagen

⁴Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen

Full Text

Abstract

This article explores the phenomenologically informed, theoretical and empirical research direction on self-disorders in the schizophrenia spectrum conditions. First, we describe the concept of ‘self’ that is operative in the concept of ‘self-disorders’ and we discuss how this self may be disordered or fragile in the schizophrenia spectrum. Second, we offer a detailed psychopathological presentation and discussion of 3 patients with schizophrenia. The vignettes provide paradigmatic examples of self-disorders in schizophrenia. Third, we summarize the main findings in the current empirical research on self-disorders. These findings consistently indicate that self-disorders constitute a crucial, trait phenotype of the schizophrenia spectrum.

Keywords: EASE; anomalous self-experience; schizotypal disorder

References

WHO: World Health Organization. The ICD-10 classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines. Geneva; WHO: 1992.
APA: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Arlington; APA: 2013.
Bleuler E. Dementia Praecox or the Group of Schizophrenias, trans. by J. Zinkin. New York; International Universities: 1950.
Parnas J., Bovet P., Zahavi D. Schizophrenic autism: clinical phenomenology and pathogenetic implications. World Psychiatry, 2002; 1(3): 131-136.
APA: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. Washington, DC; APA: 1994.
Andreasen N. DSM and the death of phenomenology in America: an example of unintended consequences. Schizophr Bull, 2007; 33: 108-112.
Parnas J., Bovet P. Psychiatry made easy: operation(al)ism and some of its consequences. In: Kendler K., Parnas J. (eds), Philosophical issues in psychiatry III: the nature and sources of historical science. Oxford; Oxford University Press: 2015, pp. 190-212.
Parnas J. Differential diagnosis and current polythetic classification. World Psychiatry, 2015; 14: 284-287.
Parnas J. Diagnostic epidemics and diagnostic disarray: the issue of differential diagnosis. In: Kendler K., Parnas J (eds), Philosophical Issues in Psychiatry IV. Oxford; Oxford University Press: 2017, 143-145.
Sass L.A., Parnas J.: Schizophrenia, consciousness, and the self. Schizophr Bull, 2003; 29: 427-444.
Parnas J., Møller P., Kircher T., Thalbitzer J., Jansson L., Handest P., et al. EASE: Examination of anomalous self-experience. Psychopathology, 2005; 38: 236-258.
Parnas J., Henriksen M.G. Disordered self in the schizophrenia spectrum: A clinical and research perspective. Harv Rev Psychiatry, 2014; 22: 251-265.
Hume D. A Treatise of Human Nature. New York; Oxford University Press: 2007.
Zahavi D. Thin, Thinner, Thinnest: Defining the Minimal Self. In Durt C., Fuchs T., Tewes C. (eds.), Embodiment, Enaction, and Culture. Investigating the Constitution of the Shared World. Cambridge, MA.; The MIT Press: 2017, pp. 193-199.
Zahavi D. Subjectivity and Selfhood. Investigating the First-Person Perspective. Cambridge, MA; MIT Press: 2005.
Zahavi D., Kriegel U. For-Me-Ness: What It Is and What It Is Not. In Dahlstrom D.O., Elpidorou A., Hopp W. (eds), Philosophy of Mind and Phenomenology: Conceptual and Empirical Approaches. New York; Routledge: 2016, pp. 36-53.
Zahavi D. Self and Other: Exploring Subjectivity, Empathy, and Shame. Oxford; Oxford University Press: 2014.
Sartre J.P. Being and Nothingness, trans. H. E. Barnes. London; Routledge: 2003.
Cermolacce M., Naudin J., Parnas J. The ‘minimal self’ in psychopathology: Reexamining the self-disorders in the schizophrenia spectrum. Conscious Cogn, 2007; 16: 703-714.
Nelson B., Parnas J., Sass L.A. Disturbance of minimal self (ipseity) in schizophrenia: Clarification and current status. Schizophr Bull, 2014; 40: 479-482.
Parnas J., Henriksen M.G. Schizophrenia and mysticism: A phenomenological exploration of the structure of consciousness in the schizophrenia spectrum disorders. Conscious Cogn, 2016; 43: 75-88.
Parnas J., Henriksen, M.G. Selfhood and its disorders. In: Stanghellini G., Broome M., Fusar-Poli P., Fernandez A., Rosfort R., Raballo A. (eds), The Oxford Handbook of Phenomenological Psychopa-thology. Oxford; Oxford University Press: in press.
Hart J.G. Who One Is. Book 1. Meontology of the ‘I’: A Transcendental Phenomenology. Berlin; Springer: 2009.
Henry M. The essence of manifestation, trans. Etzkorn G. The Hague; Martinus Nijhoff: 1973.
Saks E.R. The center cannot hold. New York; Hyperion: 2007.
Nagai M. The “schizophrenic” in the self-consciousness of schizophrenic patients. Hist Psychiatry, 2016; 27: 493-503.
Henriksen M.G., Parnas J. Self-disorders and schizophrenia: A phenomenological reappraisal of poor insight and noncompliance. Schizophr Bull, 2014; 40: 542-547.
Parnas J., Henriksen M.G. Disturbance of the experience of self – a phenomenologically based approach. In Waters F., Stephane M. (eds), The assessment of psychosis: a reference book and rating scales for research and practice. New York; Routledge: 2015, pp. 235-244.
Jansson L., Nordgaard J. The psychiatric interview for differential diagnosis. Switzerland; Springer: 2016.
Henriksen M.G. On incomprehensibility in schizophrenia. Phenom Cogn Sci, 2013; 12: 105-129.
Parnas J., Henriksen M.G. Subjectivity and schizophrenia: another look at incomprehensibility and treatment non-adherence. Psychopathology, 2013; 46 (5): 320-329.
Henriksen M.G., Parnas J. Clinical manifestations of self-disorders and the Gestalt of schizophrenia. Schizophr Bull, 2012; 38: 657-660.
Parnas J., Handest P. Phenomenology of Anomalous Experiences in Early Schizophrenia. Compr Psychiatry, 2003; 44: 121-134.
Henriksen M.G., Raballo A., Parnas J. The pathogenesis of auditory verbal hallucinations in schizophrenia: a clinical-phenomenological account. Philos Psychiatr Psychol, 2015; 22: 165-181.
Henriksen M.G., Nordgaard J. Self-disorders in Schizophrenia. In Stanghellini G., Aragona M. (eds), An Experiential Approach to Psychopathology. What is it like to suffer from mental disorders. New York; Springer: 2016, pp. 265-280.
Parnas J. A disappearing heritage: the clinical core of schizophrenia. Schizophr Bull, 2011; 37: 1121-30.
Parnas J. The core Gestalt of schizophrenia. World Psychiatry, 2012; 11(2): 67-69.
Bovet P., Parnas J. Schizophrenic delusions: a phenomenological approach. Schizophr Bull, 1993; 19: 579-597.
Parnas J., Handest P., Jansson L., Sæbye D. Anomalous subjective experi-ence among first-admitted schizophrenia spectrum patients: empirical investigation. Psychopathology, 2005b; 38: 259-267.
Raballo A., Sæbye D., Parnas J. Looking at the schizophrenia spectrum through the prism of self-disorders: an empirical study. Schizophr Bull, 2011; 37: 344-351.
Raballo A., Parnas J. Examination of anomalous self-experience: Initial study of the structure of self-disorders in schizophrenia spectrum. J Nerv Ment Dis, 2012; 200: 577-583.
Haug E., Lien L., Raballo A. Bratlien U., Øie M., Andreassen O.A., et al. Selective aggregation of self-disorders in first-treatment DSM-IV schizophrenia spectrum disorders. J Nerv Ment Dis, 2012; 200: 632-636.
Nordgaard J., Parnas J. Self-disorders and schizophrenia-spectrum: A study of 100 first hospital admissions. Schizophr Bull, 2014; 40: 1300-1307.
Parnas J., Handest P., Sæbye D., Jansson L. Anomalies of subjective experience in schizophrenia and psychotic bipolar illness. Acta Psychiatr Scand, 2003; 108: 126-133.
Raballo A., Parnas J. The silent side of the spectrum: schizotypy and the schizotaxic self. Schizophr Bull, 2011; 37: 1017-1026.
Koren D., Reznik N., Adres M., Scheyer R., Apter A., Steinberg T., et al. Disturbances of basic self and prodromal symptoms among nonpsychotic help-seeking adolescents. Psychol Med, 2013; 43: 1365-76.
Raballo A., Pappagallo E., Dell' Erba A., Lo Cascio N., Patane' M., Gebhardt E., et al. Self-disorders and clinical high risk for psychosis: an empirical study in help-seeking youth attending Community mental health facilities. Schizophr Bull, 2016; 42: 926-32.
Nelson B., Thompson A., Yung A.R. Basic self-disturbance predicts psychosis onset in the ultra high risk for psychosis ‘prodromal’ population. Schizophr Bull, 2012; 38: 1277-1287.
Parnas J., Raballo A., Handest P., Jansson L., Vollmer-Larsen A., Sæbye D. Self-experience in the early phases of schizophrenia: 5-year follow-up of the Copenhagen Prodromal Study. World Psychiatry, 2011; 10: 200-204.
Parnas J., Carter J., Nordgaard J. Premorbid self-disorders and lifetime diagnosis in the schizophrenia spectrum: a prospective high-risk study. Early Interv Psychiatry, 2016; 10: 45-53.
Haug E., Øie M., Andreassen O.A., Bratlien U., Raballo A., Nelson B., et al. Anomalous self-experiences contribute independently to social dysfunction in the early phases of schizophrenia and psychotic bipolar disorder. Compr Psychiatry, 2014; 55: 475-82.
Skodlar B., Parnas J. Self-disorder and subjective dimensions of suicidality in schizophrenia. Compr Psychiatry, 2010; 51: 363-6.
Haug E., Melle I., Andreassen O.A., Raballo A., Bratlien U., Øie M. et al. The association between anomalous self-experience and suicidality in first-episode schizophrenia seems mediated by depression. Compr Psychiatry, 2012; 53: 456-60.
Haug E., Øie M., Melle I., Andreassen O.A., Raballo A., Bratlien U., et al. The association between self-disorders and neurocognitive dysfunction in schizophrenia. Schizophr Res, 2012; 135: 79-83.
Nordgaard J., Revsbech R., Henriksen M.G. Self-disorders, neurocognition, and rationality in schizophrenia: A preliminary study. Psychopathology, 2015; 48: 310-316.
Nordgaard J., Handest P., Vollmer-Larsen A., Sæbye D., Thejlade Pedersen J., Parnas J. Temporal persistence of anomalous self-experience: A 5 years follow-up. Schizophr Res, 2017; 179: 36-40.
Maj M. The critique of DSM-IV operational criteria for schizophrenia. Brit J Psychiatry, 1998; 172: 458-460.

Calendar

Wrzesień 2021

Wszystkie

Pon	Wto	Śro	Czw	Pią	Sob	Nie
		01	02	03	04	05
06	07	08	09	10	11	12
13	14	15	16	17	18	19
20	21	22	23	24	25	26
27	28	29	30