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- Nordgaard, Julie, et al.
(författare)
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Associations between Self-Disorders and First-Rank Symptoms : An Empirical Study
- 2020
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Ingår i: Psychopathology. - : S. Karger AG. - 0254-4962 .- 1423-033X. ; 53:2, s. 103-110
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The diagnostic weight of the first-rank symptoms was deemphasized in DSM-5 and a similar change is expected in ICD-11. This change was motivated by a lack of solid, empirical evidence of the diagnostic significance of first-rank symptoms for schizophrenia. Yet, it seems that Schneider's original concept of first-rank symptoms was overly simplified when it was introduced in DSM-III. Specifically, it was overlooked that first-rank symptoms, in Schneider's understanding, fundamentally involve a disorder of the self. The aim here is to empirically test Schneider's claim that first-rank symptoms involve self-disorders. METHODS: In a modified, cross-sectional study of 98 first-admission patients, the relation between lifetime presence of first-rank symptoms and self-disorders was examined. Self-disorders were examined with the EASE (Examination of Anomalous Self-Experiences). RESULTS: We found an odds ratio of 1.56 (95% CI 1.10-2.21) for having first-rank symptoms for each 5-point increase in the EASE (measuring self-disorder) using a generalized linear mixed model regression. We did not find first-rank symptoms in the absence of self-disorders. CONCLUSION: The close relation between first-rank symptoms and self-disorders seems to support Schneider's original concept of first-rank symptoms. We suggest that first-rank symptoms occurring without the pervasively altered self-experiences might not be different from other psychotic phenomena in terms of their diagnostic significance. Awareness of self-disorders can help clinicians in assessing and detecting first-rank symptoms.
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