Abstract
Self-disorders have been proposed as the “clinical core” of the schizophrenia spectrum. This has been explored in recent studies using self-disorder assessment tools. However, there are few systematic discussions of their quality and utility. Therefore, a literature search was performed on Medline, Embase, PsychINFO, PubMed and the Web of Science. Studies using these assessment tools to explore self-disorders within schizophrenia spectrum disorders (SSDs) were included. A meta-analysis was performed on the outcomes of total self-disorder score and odds ratios of self-disorders, using Comprehensive Meta-Analysis software. Weighted pooled effect sizes in Hedge’s g were calculated using a random-effects model. 15 studies were included, giving a sample of 810 participants on the schizophrenia spectrum. Self-disorders showed a greater aggregation within schizophrenia spectrum groups compared to non-schizophrenia spectrum groups, as measured with the Bonn Scale for the Assessment of Basic Symptoms (Hedge’s g = 0.774, p < 0.01) and Examination of Anomalous Self-Experiences (Hedge’s g = 1.604, p < 0.01). Also, self-disorders had a greater likelihood of occurring within SSDs (odds ratio = 5.435, p < 0.01). These findings help to validate self-disorders as a core clinical feature of the broad schizophrenia spectrum.
Highlights
Self-disorders have been proposed as the “clinical core” of the schizophrenia spectrum
The average population effect (Z-statistic and its 95% Wald confidence intervals (CI)) was 2.1429 (1.0915–3.1942). This meta-analysis is among the first to explore the merit of theories which posit that SDs show a specificity within the schizophrenia spectrum, a finding that is consistent with that from two very recent previous reviews[26,27]
Our meta-analysis appears to indicate a significant magnitude of effect suggestive of a greater expression of SDs within the schizophrenia spectrum population, when compared with healthy controls (HC) and other mental illnesses (OMI)
Summary
Self-disorders have been proposed as the “clinical core” of the schizophrenia spectrum. A literature search was performed on Medline, Embase, PsychINFO, PubMed and the Web of Science Studies using these assessment tools to explore self-disorders within schizophrenia spectrum disorders (SSDs) were included. Interchangeably with ipseity, is the basic level of selfhood where a subject’s emotions, experiences and actions are given first-person ownership, agency, and awareness[15] This distinguishes SDs in the schizophrenia spectrum from self-disorder-like phenomena seen in other conditions such as personality d isorders[16,17,18]. Proponents of the ipseity disturbance model combined qualitative findings from patients with SSDs with a subgroup of BSABS items to create the Examination of Anomalous Self-experience (EASE)[7,19]
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