Basic Self-Disturbances beyond Schizophrenia: Discrepancies and Affinities in Panic Disorder - An Empirical Clinical Study.
Luís Madeira, Sergio Carmenates, Cristina Costa, Ludgero Linhares, Giovanni Stanghellini, Maria Luísa Figueira, Louis Sass
Psychopathology 2017 DOI: 10.1159/000457803 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 94 |
| Population | Hospital outpatients with panic disorder and no other medical or psychiatric comorbidity, plus healthy control subjects |
| Topics | Anxiety Philosophy of mind |
| Keywords | Ipseity Psychopathology Schizophrenia Self-disorders |
| Citations | 31 |
| Key findings | Panic disorder patients show elevated anomalous self-experiences approaching schizophrenia spectrum levels, but the pattern is dominated by derealization and depersonalization rather than core ipseity disturbance. |
Abstract
Anomalous self-experiences (ASEs), presumably involving alterations in "core" or "minimal self," have been studied as manifest in schizophrenia and its spectrum, in contrast with mood disorder and personality disorder samples. This is the first study to examine ASEs in panic disorder (PD), beginning the exploration of these disturbances of subjectivity in anxiety disorders. We aimed to clarify what might, or might not, be specific to the schizophrenia spectrum domain - which, in turn, could be useful for developing pathogenetic models for various disorders. 47 hospital outpatients with PD and no other medical and psychiatric comorbidity and 47 healthy control (HC) subjects were assessed with the Examination of Anomalous Self Experiences (EASE) and Cambridge Depersonalization Scale (CDS). All our PD patients had overall ASE and EASE scores significantly higher than our HCs (mean ± SD 17.94 ± 11.88 vs. HC 1.00 ± 1.81), approaching levels found in previous schizophrenia spectrum samples. The distribution of particular EASE items and subitems in the PD sample was heterogeneous, varying from rare (<10%) or absent (termed "discrepancies" with schizophrenia spectrum: 29 items) to being present in >50% of subjects ("affinities" with schizophrenia spectrum: 7 items). EASE and CDS scores were highly correlated (r = 0.756, 95% CI 0.665-0.840). PD patients scored higher on items suggesting common forms of derealization and depersonalization, perhaps suggesting "secondary" and defensive psychological processes, while lacking indicators of more profound ipseity disturbance. Our study supports the basic-self-disturbance model of schizophrenia, while suggesting the possibility of transnosological "schizophrenia-like phenomena," which might require careful phenomenological exploration to be distinguished from those of true psychotic or schizophrenic conditions.
Comparable studies
Other observational and cohort studies on anxiety, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders Patients with generalized anxiety disorder or panic disorder with or without agoraphobia | 1992 | Observational cohort | n = 22 |
| Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report Patients with a depressive disorder | 2015 | Observational study | |
| Patterning of Cognitive and Somatic Processes in the Self-Regulation of Anxiety: Effects of Meditation versus Exercise Regular practitioners of physical exercise or meditation | 1978 | Retrospective study | n = 77 |
| Dynamic coupling of whole-brain neuronal and neurotransmitter systems Healthy humans | 2020 | Observational study | |
| Psychedelics not linked to mental health problems or suicidal behavior: A population study Randomly selected United States adults | 2015 | Observational cohort | n = 135,095 |
Citations in the library
Cited by 9
- Disorder of Selfhood in Schizophrenia: A Symptom or a Gestalt? Psychopathology 2022
- Towards integrating phenomenology and neurocognition: Possible neurocognitive correlates of basic self-disturbance in schizophrenia Current Problems of Psychiatry September 1, 2017
- Self and world experience in non-affective first episode of psychosis. Schizophrenia Research September 1, 2019
- The self, neuroscience and psychosis study: Testing a neurophenomenological model of the onset of psychosis Early Intervention in Psychiatry July 2, 2023
- Psychotic-like anomalous self-experiences in feeding and eating disorders: Their role in eating psychopathology through the mediation of body uneasiness and embodiment and identity disorders. Early Intervention in Psychiatry November 1, 2024
and 4 more in the library
Cites 14
- Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. American Journal of Psychiatry 2003
- Self-disturbance and schizophrenia: structure, specificity, pathogenesis (Current issues, New directions). Schizophrenia Research 2014
- Anomalous self-experience in depersonalization and schizophrenia: a comparative investigation. Consciousness and Cognition June 1, 2013
- A Test of the Psychedelic Model of Altered States of Consciousness Archives of General Psychiatry July 1, 1976
- Introspection and schizophrenia: a comparative investigation of anomalous self experiences. Consciousness and Cognition September 1, 2013
and 9 more in the library