Three grades of subjective experiences in schizophrenia: their phenomenology and implications for initial treatment.

Abstract

Subjective experiences (SEs) in schizophrenia are sometimes neglected in operationalized diagnostics because schizophrenic patients often distort reality. Nevertheless, they sometimes report the peculiar nature of their experiences in a form of SEs. Two cases are presented to show the characteristic forms of SEs, which represent awareness of disturbed experiences of reality. They correspond to SEs in the third grade (SE3s), while SEs in the first grade consist of general subjective symptoms regarding mental and nervous conditions and those in the second grade indicate awareness of deficits in mental functions. Showing an intermediate nature between real and imaginary, SEs as well as first-rank symptoms perplex patients in the initial stage of the illness. Labeling SE3s as symptoms might successfully reduce the distress and anxiety of patients and be helpful in introducing them to long-lasting pharmacotherapy.