Parnas Josef, Carter John, Nordgaard Julie
Center for Subjectivity Research, University of Copenhagen, Copenhagen, Denmark.
Psychiatric Center Hvidovre, University of Copenhagen, Hvidovre, Denmark.
Early Interv Psychiatry. 2016 Feb;10(1):45-53. doi: 10.1111/eip.12140. Epub 2014 Apr 11.
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.
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.
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.
The results support the notion of self-disorders as a core vulnerability feature in schizophrenia, detectable premorbidly in those developing later schizophrenia-spectrum disorders.
许多基础文献中都提出了自我紊乱这一概念，认为它是精神分裂症的核心障碍。受异常自我体验检查（EASE）发展的推动，近期研究似乎表明自我紊乱是精神分裂症易感性的一种特殊表现。对寻求帮助的患者、前驱期患者和首次入院患者的随访研究已证明自我紊乱对预测后期精神分裂症谱系障碍具有实用性。我们希望通过评估自我紊乱在精神分裂症高风险的病前非临床人群中的预测价值来扩展这些发现。
对哥本哈根高风险项目中具有高精神分裂症遗传风险的儿童（N = 212）进行病前评估（平均年龄 = 15岁），并在10年和25年后进行诊断性重新评估。由于在病前评估时无法使用EASE，我们假设从明尼苏达多相人格调查表（MMPI）中提取的一个替代量表可以区分后来发展为精神分裂症谱系障碍的患者（N = 68）和保持健康的患者（N = 64）。自我紊乱量表由32个项目组成，其内容表明了EASE所测量的自我紊乱的一个方面。
病前自我紊乱量表得分显著预测了高风险队列中的终生精神分裂症谱系诊断。尽管新量表与现有的MMPI量表（精神病态量表）之间存在相当多的项目重叠，但这种重叠并不能解释自我紊乱量表的预测效力。
结果支持自我紊乱是精神分裂症核心易感性特征的观点，在后来发展为精神分裂症谱系障碍的个体中，病前即可检测到这一特征。
