Understanding basic self-disturbance and depersonalization phenomena in clinical high risk for psychosis – a case study

Poster C135, Saturday, October 22, 11:30 am - 1:00 pm, Le Baron

Tor Gunnar Værnes1, Jan Ivar Røssberg2, Paul Møller3; 1Oslo University Hospital, Norway, 2Oslo University Hospital, Norway, 3Vestre Viken Hospital Trust, Norway

Background. Basic self-disturbances (BSD) are assumed to constitute the clinical core of schizophrenia spectrum disorders (SSD) and precede the onset. Therefore, assessing BSD in clinical high-risk (CHR) populations has been suggested as a “close-in” strategy to find those with highest risk of developing psychosis, particularly SSD. However, there is a considerable overlap between BSD phenomena and the symptoms characterizing the unclearly related condition depersonalization disorder (DPD). Aims. Firstly, we wanted to explore and discuss certain aspects of BSD, particularly the depersonalization and derealization phenomena, in two CHR-conditions, namely schizotypal personality disorder (SZP) and DPD. Based on this, we secondly wanted to discuss the close-in strategy of assessing BSD in CHR populations. Method. Two single CHR-cases were chosen from an ongoing CHR-study, and qualitatively in-depth analyzed with respect to chronology, symptomatology and psychopathological pathways. Results. The two patients revealed quite similar symptoms of BSD. However, the symptoms had an insidious early childhood onset in the schizotypal patient and an abrupt adolescence onset in the depersonalization patient. Other CHR-symptoms were meaningfully related to BSD-phenomena in both patients. The schizotypal patient revealed more psychotic-like ideas related to experiences of passivity and influence than the depersonalization patient. Discussion. With respect to BSD-phenomena in CHR conditions, DPD and SZP display many common features. Differences intrinsic to the psychopathological development of BSD, combined with differences in other vulnerability factors and personal stressors, may explain differences between patients regarding the tendency for further delusional elaborations based on the presence of anomalous self-experiences.

Topic Area: Ultra High Risk / Prodromal Research

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