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Associations between Self-Disorders and First-Rank Symptoms: An Empirical Study

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@article{a12bef1659394aaab64cd05bf85cf998,
title = "Associations between Self-Disorders and First-Rank Symptoms: An Empirical Study",
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.",
keywords = "Anomalous self-experience, Diagnoses, EASE, Psychosis, Schizotypal disorder, Schneiderian, Diagnostic and Statistical Manual of Mental Disorders, Cross-Sectional Studies, Humans, Male, Adult, Female, Psychotic Disorders/diagnosis",
author = "Julie Nordgaard and Henriksen, {Mads Gram} and Jonas Berge and {Siersb{\ae}k Nilsson}, Lars",
note = "{\textcopyright} 2020 S. Karger AG, Basel.",
year = "2020",
doi = "10.1159/000508189",
language = "English",
volume = "53",
pages = "103--110",
journal = "Psychopathology",
issn = "0254-4962",
publisher = "S./Karger AG",
number = "2",

}

RIS

TY - JOUR

T1 - Associations between Self-Disorders and First-Rank Symptoms

T2 - An Empirical Study

AU - Nordgaard, Julie

AU - Henriksen, Mads Gram

AU - Berge, Jonas

AU - Siersbæk Nilsson, Lars

N1 - © 2020 S. Karger AG, Basel.

PY - 2020

Y1 - 2020

N2 - 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.

AB - 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.

KW - Anomalous self-experience

KW - Diagnoses

KW - EASE

KW - Psychosis

KW - Schizotypal disorder

KW - Schneiderian

KW - Diagnostic and Statistical Manual of Mental Disorders

KW - Cross-Sectional Studies

KW - Humans

KW - Male

KW - Adult

KW - Female

KW - Psychotic Disorders/diagnosis

UR - http://www.scopus.com/inward/record.url?scp=85089204508&partnerID=8YFLogxK

U2 - 10.1159/000508189

DO - 10.1159/000508189

M3 - Journal article

C2 - 32610320

VL - 53

SP - 103

EP - 110

JO - Psychopathology

JF - Psychopathology

SN - 0254-4962

IS - 2

ER -

ID: 60329081