Diagnosing Schizophrenia in the Initial Prodromal Phase

Klosterkötter, Joachim; Hellmich, Martin; Steinmeyer, E. M.; Schultze‐Lutter, Frauke

doi:10.1001/archpsyc.58.2.158

Cited by 918 publications

(247 citation statements)

References 22 publications

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“…Alternatively, social impairments in schizophrenia have been described as being related to a 'loss of natural evidence' for being in a world that is implicitly and intersubjectively shared with others. Such a state, it has been argued, can easily lead to alienation and social withdrawal, which may culminate in a psychotic crisis, in which the lost intersubjective meanings are replaced by a private world of delusions [88,89]. The latter aspects have been related to the negative symptom dimension of schizophrenia, which is known to be highly relevant for prognosis and socio-economic outcome [90,91].…”

Section: (D) the Case Of Schizophreniamentioning

confidence: 99%

Towards a second-person neuropsychiatry

Schilbach

2016

Phil. Trans. R. Soc. B

212

176

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Psychiatric disorders can affect our ability to successfully and enjoyably interact with others. Conversely, having difficulties in social relations is known to increase the risk of developing a psychiatric disorder. In this article, the assumption that psychiatric disorders can be construed as disorders of social interaction is reviewed from a clinical point of view. Furthermore, it is argued that a psychiatrically motivated focus on the dynamics of social interaction may help to provide new perspectives for the field of social neuroscience. Such progress may be crucial to realize social neuroscience's translational potential and to advance the transdiagnostic investigation of the neurobiology of psychiatric disorders

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Section: (D) the Case Of Schizophreniamentioning

confidence: 99%

Towards a second-person neuropsychiatry

Schilbach

2016

Phil. Trans. R. Soc. B

212

176

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“…In order to rediscover the diagnostic and prognostic value of psychotic patients' subjective and intersubjective experience, some authors developed specific standardized instruments [4,5], based on phenomenological concepts. Such attempts provided two reliable and predictive tools [4,5,6,7,8] for assessing the subtle abnormalities of patients' self-experience and intersubjective world construction, and they showed the possibility of a rich and successful integration between scientific methodology and the exploration of subjectivity.…”

Section: Introductionmentioning

confidence: 99%

Assessing Clinician's Subjective Experience during Interaction with Patients

et al. 2013

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Background: While psychiatric literature has shown renewed interest in fine psychopathological investigation, little study has been devoted to the clinician's subjective experience with the patient, which is highly valued by the phenomenological and psychodynamic traditions. We aimed at developing a valid and reliable instrument to measure such experience. Sampling and Methods: First, 104 self-report items were developed, based on daily clinical practice and references from the literature on clinician's subjective experience. Of these, 46 were retained after pilot testing and exclusion of items with poor psychometric properties. Thirteen psychiatrists and 527 first-contact patients participated in the validation study. Psychiatrists completed the ‘Assessment of Clinician's Subjective Experience' (ACSE) instrument and the Brief Psychiatric Rating Scale (BPRS) after the visit and the Profile of Mood State (POMS) before and after it. The ACSE was completed again for 60 patients with stable BPRS scores over a short retest interval. Principal component analysis with orthogonal rotation was performed. The internal consistency and test-retest stability of ACSE factorially derived scales were calculated. Convergent validity was tested by examining the correlations between ACSE scores and change in POMS scores during the visit. Results: Five factors (interpreted as tension, difficulty of attunement, engagement, disconfirmation, impotence) accounting for 57% of total variance were extracted. All ACSE scales showed high internal consistency and stability, and correlated with conceptually related POMS scales. Conclusions: The pattern of subjective experience identified by the ACSE is consistent with classical psychopathological descriptions and previous related studies. Despite limitations such as the relatively small number of psychiatrists studied and the exclusively self-report nature of the instrument, this study supports the validity and reliability of the ACSE and suggests that it may be a valuable tool for training, research and possibly diagnostic purposes.

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“…Moreover, BSs represent a link between a phenomenological approach to psychopathology and a categorical approach based on positive and negative symptoms. Specifically, BSs could gradually increase in number and severity, even many years before psychosis onset, and finally develop into psychotic symptoms, such as negative and positive symptoms [39,65]. Interestingly, we did not detect any relationship between activation patterns and positive and negative symptoms, and the correlation between altered activation patterns in SCZ and BSs was independent of positive and negative symptoms.…”

Section: Discussionmentioning

confidence: 55%

“…SCZ patients were evaluated by the Structured Clinical Interview for DSM-IV axis I disorders [37], rated for symptom severity with the Positive and Negative Symptom Scale (PANSS) [38] and evaluated for the presence of basic symptoms (BSs) [39] by means of the Schizophrenia Proneness Instrument [39] by two trained psychiatrists. HC participants were evaluated by means of the Structured Clinical Interview for DSM-IV axis II personality disorders [40].…”

Section: Methodsmentioning

confidence: 99%

Binding Action and Emotion in First-Episode Schizophrenia

Ferri

Costantini

Salone³

et al. 2014

Psychopathology

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Background/Aims: Several components of social cognition are compromised in schizophrenia (SCZ) from the early stage of the illness. In this study we first investigated whether mirror neuron-driven embodied simulation (mnES) is altered in first-episode SCZ. Second, we tested whether emotional cues impact on the mnES in SCZ patients. Methods: Twenty-two SCZ patients and 22 healthy controls (HCs) observed goal-related actions in either a neutral or emotional context during functional magnetic resonance imaging scanning. Results: Observation of neutral action elicited a lower activity in the frontoparietal network in SCZ patients, as compared to HCs. Particularly, activation in the left inferior parietal lobule in response to the same condition negatively correlated with patients' self-experience disturbances. Moreover, observation of an action performed by an angry agent produced poorer neural activity in the right anterior insula in SCZ patients as compared to HCs. This difference was mostly due to the negative β-values shown by SCZ patients, which positively correlated with their empathy scores. No differences were found contingent upon the observation of an action performed by a happy agent. Conclusion: Our results show that emotional cues allow SCZ patients to partially recover mnES. However, their understanding of the emotional components of the actions of others will likely remain deficient.

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Diagnosing Schizophrenia in the Initial Prodromal Phase

Cited by 918 publications

References 22 publications

Towards a second-person neuropsychiatry

Towards a second-person neuropsychiatry

Assessing Clinician's Subjective Experience during Interaction with Patients

Binding Action and Emotion in First-Episode Schizophrenia

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