COVID-19 influenced the content of auditory hallucinations and delusions for many people with psychosis, but the effect was not uniform. Some patients reported that ideas about the virus appeared in their hallucinations and shaped paranoid thoughts, and a few felt the frequency or loudness of voices increased. Others said the virus had not affected their experience. The increased social isolation, financial insecurity, and socio-political climate of the pandemic period also seemed to negatively impact individuals with psychosis. The findings illustrate how societal and external factors can shape the experience of psychosis.
Depersonalization (DP) and derealization (DR) are alterations in sense of self and lifeworld that often co-occur in psychosis. Over 20 years, the Chicago Longitudinal Study examined these phenomena across psychiatric categories. DP was broadly distributed across diagnoses, while DR showed greater specificity to schizophrenia. Network analyses revealed three foundational constructs in schizophrenia: alteration in sense of self/lifeworld, multisensory experiences, and bodily experiences; bodily and multisensory alterations were foundational in affective-psychosis. Self-disturbance emerged as foundational only in schizophrenia. The findings support reframing DP and DR as points on a continuum of attenuated alterations in sense of self and lifeworld, representing a fundamental self-disturbance in existential feeling.
People with higher levels of depersonalization—a feeling of being detached from one's own body or mind—tend to have more difficulty identifying and describing their emotions (alexithymia). Using a computerized body-mapping task, individuals with high versus low depersonalization showed different patterns of where they feel emotions in the body. Those with more depersonalization reported more diffuse and less localized bodily sensations for certain high-arousal emotions, such as fear or anger. This suggests that depersonalization does not simply numb all emotions; instead, it may involve an altered, less specific awareness of some intense emotional states.