Premorbid self-disorders and lifetime diagnosis in the schizophrenia spectrum: a prospective high-risk study. 2016

Josef Parnas, and John Carter, and Julie Nordgaard
Center for Subjectivity Research, University of Copenhagen, Copenhagen, Denmark.

OBJECTIVE The notion of a disordered self as a core disturbance of schizophrenia was proposed in many foundational texts. Recent studies, spurred by the development of the Examination of Anomalous Self-Experience (EASE), seem to indicate that self-disorders are a specific manifestation of schizophrenia vulnerability. Follow-up studies of help-seeking, prodromal and first-admission patients have demonstrated the utility of self-disorders for predicting later schizophrenia-spectrum disturbance. We wished to extend these findings by gauging the predictive value of self-disorders in a premorbid, non-clinical population at high risk for schizophrenia. METHODS Children from the Copenhagen High-Risk Project with high-genetic risk for schizophrenia (N = 212) were assessed premorbidly (average age = 15), and diagnostically re-evaluated after 10 and 25 years. Since the EASE was not available at the time of premorbid assessment, we hypothesized that a proxy scale drawn from the Minnesota Multiphasic Personality Inventory (MMPI) could distinguish those who later developed a schizophrenia-spectrum disorder (N = 68) from those who remained healthy (N = 64). The Self-Disorder Scale comprised 32 items whose content suggested an aspect of self-disorder as measured by the EASE. RESULTS Premorbid Self-Disorder Scale scores significantly predicted lifetime schizophrenia-spectrum diagnosis in the high-risk cohort. Although there was considerable item overlap between the new scale and an existing MMPI scale (psychoticism), the overlap did not account for the Self-Disorder Scale's predictive efficacy. CONCLUSIONS The results support the notion of self-disorders as a core vulnerability feature in schizophrenia, detectable premorbidly in those developing later schizophrenia-spectrum disorders.

UI MeSH Term Description Entries
D008297 Male Males
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D012559 Schizophrenia A severe emotional disorder of psychotic depth characteristically marked by a retreat from reality with delusion formation, HALLUCINATIONS, emotional disharmony, and regressive behavior. Dementia Praecox,Schizophrenic Disorders,Disorder, Schizophrenic,Disorders, Schizophrenic,Schizophrenias,Schizophrenic Disorder
D012565 Schizophrenic Psychology Study of mental processes and behavior of schizophrenics. Psychology, Schizophrenic
D062706 Prodromal Symptoms Clinical or physiological indicators that precede the onset of disease. Prodromal Characteristics,Prodromal Period,Prodromal Signs,Prodromal Stage,Prodromal States,Prodromal Syndromes,Characteristic, Prodromal,Characteristics, Prodromal,Period, Prodromal,Periods, Prodromal,Prodromal Characteristic,Prodromal Periods,Prodromal Sign,Prodromal Stages,Prodromal State,Prodromal Symptom,Prodromal Syndrome,Sign, Prodromal,Signs, Prodromal,Stage, Prodromal,Stages, Prodromal,State, Prodromal,States, Prodromal,Symptom, Prodromal,Symptoms, Prodromal,Syndrome, Prodromal,Syndromes, Prodromal

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