The Association between Anomalous Self-experiences, Self-esteem and Depressive Symptoms in First Episode Schizophrenia

Abstract

Background: Anomalous self-experiences (ASEs) aggregate in schizophrenia spectrum disorders, but the relationship between ASEs, and depression has been studied to a limited extent. Lower self-esteem has been shown to be associated with depression in early psychosis. Our hypothesis is that ASEs in early phases of schizophrenia are linked to lower levels of self-esteem, which in turn is associated with depression.Aim: The aim is to examine the relationship between ASEs, self-esteem and depression in first-episode schizophrenia spectrum disorders.Method: ASEs were assessed in 55 patients with first-episode schizophrenia by means of the Examination of anomalous Self-Experience (EASE) instrument. Assessment of depression was based on the Calgary Depression Scale for Schizophrenia (CDSS). Self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES). Symptom severity was assessed using the Structured Clinical Interview for the Positive and Negative Syndrome Scale (SCI-PANSS). Substance misuse was measured with the Drug Use Disorder Identification Test (DUDIT), and alcohol use was measured with the Alcohol Use Disorder Identification Test (AUDIT). Data on childhood adjustment were collected using the Premorbid Adjustment Scale (PAS). Data on childhood trauma were collected using the Norwegian version of the Childhood Trauma Questionnaire, short form (CTQ-SF).Results: Analyses detected a significant association between current depression and ASEs as measured by the EASE in women, but not in men. The effect of ASEs on depression appeared to be mediated by self-esteem. No other characteristics associated with depression influenced the relationship between depression, self-esteem and ASEs.Conclusion: Evaluating ASEs can assist clinicians in understanding patients' experience of self-esteem and depressive symptoms. The complex interaction between ASEs, self-esteem, depression and suicidality could be a clinical target for the prevention of suicidality in this patient group.

Clinical and psychosocial factors associated with depression in patients with psychosis according to stage of illness

“…The association between longer DUP and depression in patients with first‐episode psychosis was also consistent with previous studies (Haug et al, ; Marshall et al, ). Depression might develop if psychotic symptoms are persistent.…”

“…Many studies have demonstrated that traumatic experience in childhood is a risk factor for schizophrenia. Childhood trauma is also associated with depression in patients with schizophrenia (Alameda et al, ; Haug et al, ; Haug et al, ). In particular, our study demonstrated that childhood trauma was associated with depression at the time of the first treatment of a psychotic episode but not during the stabilization phase.…”

Stability in basic self-disturbances and diagnosis in a first treated psychosis: A seven year follow-up study

“…Both SOC and BSDs are closely linked to the clinical severity of mental illness [20][21][22][23][24][25][26][27][28], more knowledge about the relationship between SOC and BSDs give us insight into the challenges experienced by people with schizophrenia and other psychotic disorders. We here aim to investigate the relationship between BSDs and SOC in patients with psychotic disorders.…”

Early persistence of psychotic‐like experiences in a community sample of adolescents

“…One of the most widely investigated factors is depression which has tended to be higher in persistent groups although not always significantly. Personality traits, functioning, self‐esteem, suicidality and psychological distress (Haug et al, 2016; Nishida et al, 2010; Shi et al, 2018; Yamasaki et al, 2018) have been found to be associated with PLE prevalence.…”