Study of cenesthesias and body image aberration in schizophrenia

Abstract

Background:Abnormal body sensations are reported frequently by schizophrenic patients. Cenesthesias are infrequently recognized and diagnosis of cenesthopathic schizophrenia is rarely made. There are very few studies regarding the same.Aims and Objectives:To assess cenesthesias and different aspects of body image aberration and their relationship with psychopathology in patients with paranoid schizophrenia.Materials and Methods:Seventy patients of paranoid schizophrenia meeting the inclusion and exclusion criteria were assessed with Positive and Negative Symptom Scale(PANSS) for psychopathology, Bonn Scale for Assessment of Basic Symptoms/Category D ‘Cenesthesias’ (BSABS), Image-Marking Procedure(IMP), alteration of body size and body cathexis. Assessments were made at baseline and after two weeks and assessed with SPSS 12.0.Results:The most commonly endorsed items on BSABS were depersonalization, motor weakness, abnormal pain, numbness and stiffness. Patients underestimated lower extremities and feelings of body size change which was positively correlated with PANSS-scores and improved on reassessment. Cenesthesias were positively correlated with disturbances of body concept and were present at onset in 40% and change form in 75.7%.Conclusions:Cenesthesias and body image aberrations are common in paranoid schizophrenia. They are present from onset in few, change form and improve on treatment. Cenesthesias and disturbances of body concept are correlated and body size is associated with other psychopathology.

Cenesthopathy and Subjective Cognitive Complaints: An Exploratory Study in Schizophrenia

“…Our results did not confirm other unusual cenesthetic basic symptoms described previously, including D.2, bodily sensations of motor weakness, "paralysis" [38], and D.14, dysesthetic crisis (unusual bodily sensations plus central-vegetative disturbances or fear of dying at any minute) [36].…”

“…Concerning the most uncommon cenesthetic basic symptoms, in our study using the BSABS all items appeared in at least 10% of patients; the lowest prevalence was 13.3% for 3 types: D.4, migrating sensations, "wandering" through the body; D.10, kinesthetic sensations, and D.12, dysesthesias provoked by different stimuli, which confirmed previous results for D.4 [13,16,36,38], D10 [16,36], and D.13 [13]. Our results did not confirm other unusual cenesthetic basic symptoms described previously, including D.2, bodily sensations of motor weakness, "paralysis" [38], and D.14, dysesthetic crisis (unusual bodily sensations plus central-vegetative disturbances or fear of dying at any minute) [36].…”

“…The most frequent type of cenesthetic basic symptom, found in 51 subjects with potential prodromal symptoms of schizophrenia (mean age, 25.5 years, 18% women), was the already mentioned D.8 (23.5% of the sample and 30% in our study); most cenesthetic basic symptoms (D.6, D.3, D.14, D.11, D.1, D.1.1, D.7, D.5) appeared in 10-20% of the sample [38]. Interestingly, we confirmed that all kinds of cenesthetic basic symptoms were represented in groups of patients with schizophrenia [13,16,36]; this was not observed in subjects who were at risk [38].…”

“…Interestingly, the cenesthetic basic symptoms found in at least 30% of patients are quite similar in both studies: D.1, unusual bodily sensations of numbness or stiffness; D.1.1, somatopsychic sensations of motor weakness (sensations of "paralysis"); D.8, sensations of abnormal heaviness, lightness or emptiness, of falling, sinking, levitation, or elevation [36]. D.3, circumscribed sensations of pain (30% in our study and 28.7% in the study of Rajender et al [36]), and D.9, sensations of diminution, shrinking and constriction, of enlargement or extension (30 and 25.7%, respectively), also showed comparable results.…”

“…A lower amount of cenesthetic basic symptoms, also assessed by the BSABS (mean score, 3.7; SD, 3.2; percentage of patients with any cenesthetic basic symptom, 40%), was found in a sample of 70 patients diagnosed with paranoid schizophrenia [36] with comparable age and duration of illness (mean age, 31.5 and 34.6 years, respectively; mean duration of illness, 12.8 and 9.2 years, respectively) and a higher proportion of women (26.7 and 45.7%, respectively). This fact could probably be explained by the considered period of time for assessment, the whole duration of illness in our study, according to the general instructions of the BSABS [5], and the present time in the second case [36]: in fact, total scores decreased to 2.8 (SD, 3.2) after 2 weeks of follow-up. Similarly, lower scores in cenesthetic basic symptoms were obtained in a group of 35 patients diagnosed with schizophrenia (48.6% women, mean age, 35.2 years, mean duration of illness, 9.1 years) when a 2-week time frame was applied (mean score, 0.89; SD, 0.96) [37].…”