Subjective Experience In Schizophrenia Research Articles

L'espace vécu and Its Perturbations in Schizophrenia: Systematic Review and Meta-analysis of Altered Body-Centric Metrics-Personal and Peripersonal Space.

Subtle distortions of the experience of lived space have long been associated with schizophrenia. Although a body-centric transformation of space is considered an essential component of anomalous subjective experience in schizophrenia, its impact on the 2 major body-centric spatial constructs, that is, personal space (PS) and peripersonal space (PPS), is still not clear. This systematic review and meta-analysis have been set up to: (1) summarize the evidence on putative extensional differences of PS and PPS in schizophrenia as compared with controls, and (2) evaluate the quality and the limitations of available studies on the topic. Four electronic literature databases (MEDLINE, EMBASE, PsychINFO, and CINAHL) were searched with the keywords "Personal space OR Interpersonal distance AND Schizophrenia," "Peripersonal space AND Schizophrenia" from inception until December 31, 2023, resulting in 15 studies on PS and 5 studies on PPS included in this systematic review. The 12 studies on PS included in the meta-analysis revealed that individuals with a diagnosis of schizophrenia place a larger interpersonal distance from the stimuli than controls, with a moderate effect size in both the fixed-effect model (Hedges' g = 0.558 [95% confidence interval, CI: 0.445-0.671]; z = 9.67; P < 0.0001) and the random effects model (0.547 [0.294-0.799]; z = 4.77; P = 0.0006). The 5 studies included in the meta-analysis on PPS showed that individuals with a diagnosis of schizophrenia exhibit a narrower PPS than the controls at the fixed-effect (Hedges' g = 1.043 [95%CI: .739-1.348]; z = 6.72; P < .0001), but not at the random effects model (1.318 [-0.721 to 3.359]; z = 1.79; P = .147). Heterogeneity was substantial in both meta-analyses. Overall, the findings indicate that both body-centered space constructs (PS and PPS) are affected in schizophrenia, with an enlargement PS and a reduction PPS, thereby supporting the distinction of these constructs. These modifications cohere with the subjective transformation of the lived space (aka espace vécu) reported in classical psychopathology and may be promising, neurodevelopmentally grounded, biomarkers of vulnerability to schizophrenia and its spectrum conditions.

Peripersonal Space Plasticity in Relation to Psychopathology and Anomalous Subjective Experiences in Individuals With Early-Onset and Adult-Onset Schizophrenia.

Individuals with schizophrenia present anomalies in the extension and plasticity of the peripersonal space (PPS), the section of space surrounding the body, shaped through motor experiences. A weak multisensory integration in PPS would contribute to an impairment of self-embodiment processing, a core feature of the disorder linked to specific subjective experiences. In this exploratory study, we aimed at: (1) testing an association between PPS features, psychopathology, and subjective experiences in schizophrenia; (2) describing the PPS profile in individuals with early-onset schizophrenia. Twenty-seven individuals with schizophrenia underwent a task measuring the PPS size and boundaries demarcation before and after a motor training with a tool. The Positive And Negative Syndrome Scale (PANSS), the Examination of Anomalous Self Experience scale (EASE) and the Autism Rating Scale (ARS) were used to assess psychopathology. Subsequently, participants were divided into two subgroups, early and adult-onset schizophrenia. The two groups were compared in regard to their PPS and psychopathological profiles. PPS patterns were associated with psychopathology, particularly positively with PANSS negative scale score, and negatively with subjective experiences of existential reorientation (EASE Domain 5 scores) and of social encounters (ARS scores). Only PPS parameters and ARS scores differentiated between early and adult-onset participants. Our results, although preliminary and exploratory, can suggest a link between PPS patterns, negative symptoms, and disturbances of the subjective experience, particularly in the intersubjective domain, in schizophrenia. Moreover, they seem to suggest that specific PPS profiles and schizophrenic autism traits could be markers of early-onset schizophrenia.

Peripersonal space plasticity, Self-disorders and intersubjectivity in patients with early-onset and adult-onset schizophrenia

Introduction In schizophrenia, there is evidence for anomalies in the extension and plasticity of the peripersonal space (PPS), the portion of space surrounding our body, plastically shaped through motor experiences. An impaired multisensory integration at the PPS level would underpin the disembodiment, a core feature of the disorder linked to subjective perturbations of the sense of self (“Self-disorders”) and of the intersubjective dimension (“schizophrenic autism”). Objectives The present study was aimed at: 1) exploring possible associations between PPS data, psychopathological dimensions, and subjective experiences in schizophrenia; 2) identifying a specific PPS profile in patients with early-onset schizophrenia. Methods A motor training with a tool was used to assess the PPS size and boundaries demarcation in twenty-seven schizophrenia outpatients. Moreover, they underwent a thorough psychopathological evaluation with the Positive And Negative Syndrome Scale (PANSS), the Examination of Anomalous Self Experience scale (EASE) and the Autism Rating Scale (ARS). Subsequently, the sample was divided into early (EOS) and adult-onset (AOS) subgroups, that were compared with respect to their PPS and psychopathological profiles. Results PPS features (size and boundaries demarcation) were associated with PANSS negative score, subjective experiences of existential reorientation (EASE Domain 5 scores) and traits of schizophrenic autism (ARS scores; Fig. 1). PPS parameters (Fig. 2) and ARS scores, but not PANSS and EASE differentiated between early and adult-onset subgroups. Image: Image 2: Conclusions Our results suggest a link between PPS patterns, negative symptoms, and disturbances of the subjective experience, particularly in the intersubjective domain, in schizophrenia. Moreover, they candidate specific PPS profiles and schizophrenic autism traits as EOS markers. Disclosure of Interest None Declared

The concept of psychotic arousal and its relevance to abnormal subjective experiences in schizophrenia. A hypothesis for the formation of primary delusions

The presence of abnormal subjective experiences in the prodromal stages of schizophrenia as well as their contribution to delusional formation have been highlighted in psychiatric literature, but their nature and their involvement in the transition and establishment of full-blown psychosis remains elusive. In this paper, we venture to form a coherent hypothesis for the formation of primary delusions by attributing importance to the emotional and affective symptoms experienced by patients during the acute state of psychosis. We underline the presence of abnormal subjective experiences described as ‘feelings’ in patients’ narratives, their co-occurrence with discernible emotional manifestations and symptoms, and their rather simultaneous retreat from the clinical picture shortly after the effective administration of antipsychotic treatment. We further distinguish them from their enveloping thought content, on the base of their different course pattern and natural characteristics. We argue that this composite emotional picture – which we call “psychotic arousal” – though resembling the acknowledged “delusional mood”, traverses the acute state of psychosis to a greater extent and intensity, as long as we observe delusions flourishing and expanding. We specifically suggest that altered subjective experiences can be seen as emotional in nature and best described as “experiential feelings”. Consequently, we reflect upon neuroscientific theories and models supporting a layered concept for the formation of consciousness that attribute a paramount role on emotions as a representation of neural maps of the material body’s state. We explore patients’ “experiential feelings” as the morbid outcome of an otherwise normal process and we provide a theoretical solution for the psychotic transition and the formation of primary delusions. Our hypothesis, eventually, responds to long-standing questions regarding the content of the delusions, their abrupt appearance, their self-referential character, their selectivity and specificity, as well as their impact on awareness and the erroneous deployment of extended consciousness. We suggest that further enquiry of the proposed hypothesis could elucidate more deeply the phenomenology of schizophrenia and benefit both psychopathology and neuroscience of self.

Patient-reported impact of symptoms in schizophrenia scale (PRISS): Development and validation.

We report the psychometric properties of the Patient-Reported Impact of Symptoms in Schizophrenia Scale (PRISS), which assesses the impact of subjective experiences or qualia in outpatients with this condition. A cross-sectional study was carried out in 162 patients diagnosed with schizophrenia in Spain. The PRISS measures the presence, frequency, concern and interference with daily life of self-reported experiences related to the main symptoms observed in these patients. The psychometric analysis included test-retest reliability, internal consistency and structural and convergent validity. The 28-item PRISS showed good test-retest reliability as 64.3% of the intraclass correlation coefficient values were between 0.40 and 0.79, which were statistically significant (p<0.01). Analysis of the structural validity revealed a three-factor structure, (1) productive subjective experiences, (2) affective-negative subjective experiences and (3) excitation, which accounted for 56.11% of the variance. Of the Pearson's correlation coefficients analysed between the PRISS and the Positive and Negative Syndrome Scale (PANSS), Scale for Assessment of Negative Symptoms (SANS) and World Health Organization Disability Assessment Schedule (WHO-DAS), 72.2% were statistically significant (p<0.05) and ranged from 0.38-0.42, 0.32-0.42 and 0.40-0.42, respectively. Our results indicate that the PRISS appears to be a brief, reliable and valid scale to measure subjective experiences in schizophrenia and provides valuable information complementary to clinical evaluation.

Experience of Subjective Symptoms in Euthymic Bipolar Disorder and Remitted Schizophrenia Patients and its Relation with Quality of Life and Social Functioning

Introduction : Subjective experience means subtle, not yet psychotic abnormalities of experience that might be present during remitted phase and also in prodromal phase of schizophrenia and might be accurately efficient in identifying individual at risk of eminent psychosis. Most studies on the subjective experiences have been conducted in schizophrenia and to a lesser extent in affective disorders.Only few studies have compared subjective experience of patients with bipolar disorder with the patients with schizophrenia, and the results were inconsistent. These subjective experiences may be related to distorted cognitive functions in these patients. Cognitive deficits are a major contributor to the functional and social impairment suffered by these patients and have been noted to have more of an impact on the daily lifeand overall quality of life of these patients. Objective : The current study aims at comparing the subjective experience in schizophrenia and bipolar patients, in order to elucidate the difference between the two groups and this study was further extended to measure the effect of subjective experiences on one’s occupational and social functioning. Method : The study was conducted on 30 euthymic bipolar patients and 30 remitted schizophrenic patients diagnosed as per ICD-10. The patients were rated for on Frankfurt Complaint Questionnaire (FCQ-24) and Symptoms check list 90 revised (SCL90-R) to assess subjective symptoms. Work and social adjustment scale, functional status questionnaire and WHO-QOL BREF were administered one by one on the patient. Results : Diagnosis of schizophrenia was associated with elevated score on FCQ as compared to bipolar disorders mainly in the areas of perception, thought, language and motility as well as total FCQ scores. FCQ scores correlated negatively with scores on functional status questionnaire, positively with work and social adjustment scale and negatively with all the domains of WHOQOL BREF except environment/financial resources. Conclusion : These findings, in conjunction with those from other, methodologically similar studies, suggest that certain anomalies of subjective experience aggregate significantly in schizophrenia when compared with bipolar disorders and adversely affected their functioning and quality of life Keywords : subjective symptoms, euthymic bipolar disorder, remitted schizophrenia

Minimal Self Disorders in Schizophrenia.

In recent years we have witnessed a rebirth of interest in the field of subjectivity and its disorders, particularly the severity and quality of non-psychotic abnormal subjective experience. Contemporary research on abnormal subjective experiences in schizophrenia has used several different theoretical frameworks. The most common of these is the phenomenological approach. A prominent example of the phenomenological approach is the minimal self disorder model. In this article, we will discuss, prominent theories on the concept of 'self ', historical background of the minimal self disorder model in schizophrenia and the current approach to this model. According to this model, self disorders have been hypothesized to be an underlying and trait-like core feature of schizophrenia. The model suggests that this minimal self is disturbed in three ways in people with schizophrenia: hyperreflexivity, diminished self-affection (diminished self-presence) and disturbed grip or hold on the cognitive-perceptual world. Hyperreflexivity is defined as the excessive attention to processes that would ordinarily be implicitly experienced. Diminished self-affection (diminished self-presence) refers to an experience of a loss of self-agency. Disturbed grip or hold on the cognitive-perceptual world refers to the disturbances of spatio-temporal structuring of the experiential field. These three aspects are intimately interlinked, and should be understood more as the components of a single entity. Finally, clinical symptoms that may indicate minimal self disorder and the abnormal self experiences of two patients with a diagnosis of schizophrenia are discussed. Keywords: Schizophrenia, phenomenology, self-disorders, hyperreflexivity, diminished self-affection.

Examination of Anomalous World Experience: A Report on Reliability

Background: The EAWE (Examination of Anomalous World Experience) is a newly developed, semi-structured interview that aims to capture anomalies of subjectivity, common in schizophrenia spectrum disorders, that pertain to experiences of the lived world, including space, time, people, language, atmosphere, and certain existential attitudes. By contrast, previous empirical studies of subjective experience in schizophrenia have focused largely on disturbances in self-experience. Aim: To assess the reliability of the EAWE, including internal consistency and interrater reliability. Sampling and Methods: In the course of developing the EAWE, two distinct studies were conducted, one in the United States and the other in Slovenia. Thirteen patients diagnosed with schizophrenia spectrum or mood disorders were recruited for the US study. Fifteen such patients were recruited for the Slovenian study. Two live interviewers conducted the EAWE in the US. The Slovenian interviews were completed by one live interviewer with a second rater reviewing audiorecordings of the interview. Internal consistency and interrater reliability were calculated independently for each study, utilizing Cronbach's α, Spearman's ρ, and Cohen's κ. Results: Each study yielded high internal consistency (Cronbach's α >0.82) and high interrater reliability for total EAWE scores (ρ > 0.83; average κ values were at least 0.78 for each study, with EAWE domain-specific κ not lower than 0.73). Conclusion: The EAWE, containing world-oriented inquiries into anomalies in subjective experience, has adequate reliability for use in a clinical or research setting.

The relationship between insight and subjective experience in schizophrenia.

ObjectivesTo examine the relationship between level of insight and various subjective experiences for patients with schizophrenia.Materials and methodsSeventy-four patients with schizophrenia who were discharged from our hospital were evaluated. The level of insight into their illness and various subjective experiences were evaluated at discharge. We used the Scale to Assess Unawareness of Mental Disorder (SUMD) for evaluation of insight. In addition, five different rating scales were used to evaluate subjective experiences: Subjective Experience of Deficits in Schizophrenia (SEDS), Subjective Well-being under Neuroleptic drug treatment Short form (SWNS), Schizophrenia Quality of Life Scale (SQLS), Beck Depression Inventory (BDI), and the Drug Attitude Inventory (DAI)-30.ResultsThe SWNS and the scores for awareness of mental disorder and awareness of the social consequences of mental disorder on SUMD showed a weak positive correlation. The DAI-30 showed a significant negative correlation with most general items on SUMD and a negative correlation between the subscale scores for the awareness and attribution of past symptoms. SEDS, SWNS, SQLS, and the BDI significantly correlated with the subscale scores for awareness of current symptoms on SUMD, and weakly correlated with the subscale scores for attribution of current negative symptoms.ConclusionAwareness of subjective distress was related to awareness of having a mental disorder. Feeling subjective distress was related to awareness of current symptoms, as well as to the ability to attribute current negative symptoms to a mental disorder. Positive attitudes toward medication correlated with better general insight into the illness.

Anomalous subjective experiences in schizophrenia, bipolar disorder, and unipolar depression

BackgroundThe purpose of the present study was to compare anomalous subjective experiences in patients with schizophrenia, bipolar disorder, and unipolar depression, in order to elucidate differences in subjective experiences and examine their potential clinical correlates in schizophrenia and mood disorders. MethodsThe subjective experiences of 78 outpatients with schizophrenia (n=32), bipolar disorder (n=24) and unipolar depression (n=22), and 32 healthy controls were comprehensively assessed using the Frankfurt Complaint Questionnaire (FCQ). ResultsThe FCQ total score was significantly higher in the schizophrenia and depression groups than in the healthy control group. There were no significant differences in the FCQ total or subscale scores among the schizophrenia, unipolar depression, and bipolar disorder groups. In the schizophrenia group, the Positive and Negative Syndrome Scale negative factor score was a significant negative predictor of the severity of subjective experiences assessed by the FCQ total score. Disruption of subjective experiences in patients with unipolar depression was associated with greater severity of depressive symptoms and younger age. In the bipolar disorder group, women reported more disruptions in subjective experience. ConclusionsAnomalous subjective experiences measured by the FCQ are not specific to schizophrenia, and the severity of these experiences in unipolar depression is substantially high. The finding of a dissimilar pattern of predictors of subjective experiences across different diagnostic groups suggests the complexity and variety of factors contributing to anomalous subjective experiences in schizophrenia and mood disorders.

S16-04 - The assessment of self experiences in patients with primary negative symptoms

IntroductionNegative symptoms in schizophrenia are present both in behavior and in the subjective experiences of the patients. However the latter are not represented in most rating instruments.ObjectivesTo review assessment methods for the subjective experiences of primary negative and related symptoms in schizophrenia.MethodsLiterature review and comparison of negative symptoms as judged by the rater with reports of self experiences.ResultsThe Scale for Assessment of Negative Symptoms (SANS) is an instrument concerning the positive-negative distinction in schizophrenia. The SANS is based on the judgment of the rater about the behavior of the patient. Items reflecting subjective experiences of the patients were initially included in the SANS, buy they were not significantly correlated with the behavioral items, and were therefore excluded from this scale by its author.Huber's group emphasized subjective experiences in schizophrenia. According to this concept the lack of behavioral negative symptoms does not exclude subjective experiences of deficiencies (part of „basic symptoms”, „pure defect”). Nineteen such symptoms were included in the Subjective Deficit Syndrome Scale (SDSS).We compared negatives symptoms measured by SANS with the corresponding subjective experiences measured by SDSS in patients with the diagnosis of schizophrenia and schizoaffective disorder (n = 122).D2 receptor occupancy during antipsychotic treatment was found to be associated with subjective experiences/well being, which can be assessed with specific rating scales (e.g.: Drug Attitude Inventory and Subjective Well-Being under Neuroleptic Treatment).ConclusionsBehavioral symptoms and the subjective experiences of the negative syndrome are not correlated with each other.

Autism and Perplexity: A Qualitative and Theoretical Study of Basic Subjective Experiences in Schizophrenia

Background: Autistic traits and perplexity are considered core features of schizophrenia in phenomenological psychiatry. They express a fundamental disturbance of the self-world relation (including disturbances of self and intersubjectivity). The aim of our study was to examine this disturbance by exploring in detail how autism and perplexity are experienced subjectively. Methods: It is a qualitative single-case study. In order to fully examine our patient’s experiences within the context of his experiential world and not only as isolated or decontextualized symptoms, we applied a heideggerian framework, i.e. Heidegger’s exhaustive account of the self-world relation (care). Results: Through the framework of care, we discovered a profound disturbance of the self-world relation in our patient, characterized by subtle experiences of estrangement, anxiety and exposure. We found these experiences to be enduring, pervasive and generative for the development of other symptoms. Conclusions: We argue that these experiences can be seen as experiential correlates of schizotypy and of vulnerability to schizophrenia, and furthermore that an understanding of these experiences can play a role in diagnostic and differential diagnostic procedures, e.g. in early detection or in the search for high-risk individuals, as well as in the psychotherapy of schizophrenia.

Experiential Anomalies and Self-Centrality in Schizophrenia

Background: Contemporary psychopathological research has shown that some qualitative anomalies of the first-person experiential givenness qualify the subjective experience of schizophrenia. Such essential clinical features of schizophrenia have recently been condensed into 7 phenomenologically coherent clusters derived from the Bonn Scale for the Assessment of Basic Symptoms (BSABS). The experimental intent of this study was to test whether subapophanic self-centrality (i.e. a protopathic nondelusional form of intersubjective spatial disattunement) empowers the discriminant capacity of such a set of subjective experiential disturbances among different diagnostic groups. Method: Three comparably sized samples of outpatients with schizophrenia, obsessive-compulsive or mood disorders were examined with the BSABS. Logistic regression analysis was performed with diagnosis as the outcome variable. Results: Elevated scores in self-perceived cognitive disorders and abnormal self-centrality were associated with DSM-IV diagnosis of schizophrenia. Self-centrality increased the discriminant capacity of the 7 designed a priori dimensions. Conclusions: These findings confirm the previously reported aggregation of some subtle qualitative alterations of subjective experience in schizophrenia, and suggest that a careful consideration of autocentric disturbances of intersubjectivity might enrich current heuristics on schizophrenic experiential vulnerability.

Anomalies of subjective experience in schizophrenia and psychotic bipolar illness.

Contemporary psychopathology, as a result of behaviourally dominated epistemological stance, downplays anomalies of the patient's subjectivity. This neglect has probably deleterious consequences for research in the causes and the boundaries of the schizophrenia spectrum conditions. The purpose of this study is to explore frequency of qualitative, not-yet-psychotic, anomalies of subjective experience in patients with residual schizophrenia and psychotic bipolar illness in remission. The patients were examined with the Danish version of the Bonn Scale for the Assessment of Basic Symptoms (BSABS). Anomalies of experience were condensed into rational scales with good internal consistencies. Diagnosis of schizophrenia was associated with elevated scores on the scales measuring perplexity (loss of immediate meaning), disorders of perception, disorders of self-awareness, and marginally so, disorders of cognition. These findings, in conjunction with those from other, methodologically similar studies, suggest that certain anomalies of subjective experience aggregate significantly in schizophrenia. These experiential anomalies appear to be relevant for early differential diagnosis and therefore potentially useful in the preonset detection of the schizophrenia spectrum illness.

Neuropsychological functioning as a moderator of the relationship between psychosocial functioning and the subjective experience of self and life in schizophrenia.

Psychosocial interventions and models of quality of life in schizophrenia are based on the notion that increases in psychosocial functioning will be related to improvements in subjective experience outcomes such as self-esteem and satisfaction with life. However, studies have repeatedly failed to demonstrate a direct relationship between psychosocial functioning and subjective experience in schizophrenia. This study of 40 individuals diagnosed with schizophrenia examined whether neurocognitive measures of executive functioning moderated the relationship between psychosocial functioning and subjective experience. Subjective experience was represented by measures of satisfaction with life and self-esteem. The Global Assessment Scale measured psychosocial functioning, and the Wisconsin Card Sorting Test measured executive functioning. Multiple regression and correlation analyses indicated that executive functioning was a strong moderator. Specifically, individuals with schizophrenia with impaired executive functioning displayed a positive and statistically significant association between psychosocial functioning and both measures of subjective experience (r = 0.55 and 0.61). However, among schizophrenia patients with intact executive performance, psychosocial functioning was negatively associated with self-esteem and satisfaction with life (r = -0.24 and -0.46). And the findings were internally replicated using two other neuropsychological measures relevant to executive functioning. These findings indicate that executive functioning plays a major role in moderating the relationship between subjective experience and psychosocial functioning in schizophrenia. Implications for biosocial models, psychosocial interventions, and models of quality of life in schizophrenia are discussed.

Subjective experience in schizophrenia: factors influencing self-esteem, satisfaction with life, and subjective distress.

The relative and combined effects of individual characteristics, severity of illness, psychosocial functioning, treatment intensity, and milieu variables on self-esteem, distress and satisfaction with life were examined in a study of 103 subjects diagnosed with schizophrenia or schizoaffective disorder, all of whom had been in either high-intensity or low-intensity community-based interventions for at least six months. Implications of the findings for treatment and for research on subjective experience in schizophrenia are discussed.

Subjective experience and related symptoms in schizophrenia

We had previously extracted two types of subjective experience of schizophrenia (SES); first, a feeling of inadequacy in stream of speech, thought, and action, associated with a distorted sense of self, and second, a feeling that excessive thoughts are filling and sticking to one's head, causing negative affective burden such as misery and oppression. This study tried to validate their content using conventional symptom clusters as external validators. Subjects were 63 patients from two hospitals in Tokyo meeting ICD-10 criteria for schizophrenia. Positive, negative, and depressive psychopathology were measured by the Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of the Negative Symptoms (SANS), and Hamilton's Depression Scale (HDS). The two types of SES were measured by an original scale. The first type of SES correlated significantly with the negative symptoms of alogia, avolition, and attention, whereas the second correlated with positive and depressive symptoms. To analyze how schizophrenia is experienced by patients, qualitative and comprehensive descriptions, such as indicated by our subjective factors, will be useful.

Anhedonia and negative symptomatology in chronic schizophrenia

The relationships between negative symptomatology and anhedonia have been studied on 61 subjects who had Research Diagnostic Criteria for chronic schizophrenia. Negative symptomatology was rated by the negative subscales of the Kay Positive and Negative Syndrome Scale (PANSS) and of the Brief Psychiatric Rating Scale (BPRS). Anhedonia was rated by the Physical Anhedonia Scale of Chapman (PAS), the Fawcett-Clark Pleasure Capacity Scale-Physical Pleasure (FCPCS-PP), and the social interest subscale (SIS) of the Nurse Observation Scale for Inpatients (NOSIE30). Pearson correlations were calculated between negative and anhedonia scales. Schizophrenics were dichotomized first into negatives and positives using the composite score of the PANSS, and second into low and high negatives using the negative subscale of the PANSS. For each dichotomy, the corresponding subgroups were compared on anhedonia scales using Student's t test. The results have shown no significant correlations between negative and anhedonia scales (PAS and FCPCS-PP). There were no significant differences concerning the PAS and the FCPCS-PP between negative and positive subgroups of schizophrenics and between low- and high-negative subgroups. Anhedonia is not a negative symptom. Our results confirm the reported studies on subjective experiences in schizophrenia. A search for more restricted forms of schizophrenia characterized by severe anhedonia is needed.

An analysis of the subjective experience of schizophrenia.

To examine how varieties of the subjective experience of schizophrenia (SES) can be categorized, a self-report questionnaire consisting of 150 items from the SES in Japanese was administered to 237 Japanese schizophrenic inpatients, and the results were analyzed through a multivariate method. The first factor represents loss of focus and adequacy of thoughts, behavior, and interpersonal perception; it resembles negative symptoms and coincides with the basic symptoms of schizophrenia reported by anthropological psychiatrists. The second factor represents automatic and excessive thoughts and affective loading, and overlaps "the tremble" of Conrad and the mental automatism of de Clerambault. Both signify different combinations of experiences from conventional descriptive symptoms, and may represent more suitable ways to describe the SES.

Subjective experiences in schizophrenia: a critical review.

The current status of subjective experiences in schizophrenia is examined. Subjective experiences are very frequent disorders in schizophrenic patients, and their study has been largely neglected. Recently, a number of scales that evaluate subjective experiences have been published, and although the psychometric properties of most scales have not been sufficiently studied, they seem to have adequate interrater reliability, internal consistency, and convergent validity. A higher number of subjective experiences is associated with the female sex and is inversely correlated with the level of education and lack of insight into illness. Hypothetically, subjective experiences are ascribed to impairments of information processing; however, studies on the relationship between these symptoms and measures of information processing are scarce and contradictory. In the acute stage of the illness, subjective experiences are associated with positive symptoms, and at this stage they may reflect the process activity of schizophrenia. In the remission stage of the illness, subjective experiences are related to negative symptoms, and they constitute the subjective correlate of the psychological deficit. A theory of subjective experiences within the framework of the vulnerability/stress model of schizophrenia is proposed.