Innlandet Hospital Trust, Department of Acute Psychiatry and Psychosis Treatment, Presteseter 1, 2840 Reinsvoll, Norway; University of Oslo, Faculty of Medicine, P. B. 1018, Blindern, 0315 Oslo, Norway.
Department of Psychology, University of Oslo, Pb 1094, Blindern, Norway; Division of Research, Innlandet Hospital Trust, Norway.
Schizophr Res. 2018 Dec;202:274-280. doi: 10.1016/j.schres.2018.07.011. Epub 2018 Jul 11.
Basic self-disturbances (BSDs) are considered core features of schizophrenia spectrum disorders, and are present in the prodromal, early psychotic and chronic phases. Considerable levels of BSDs are also present at first treatment in some patients with psychotic disorders outside the schizophrenia spectrum. There is limited knowledge about the stability of self-disturbances over time.
To explore the stability of BSDs in a seven-year follow-up of first treatment patients, and the association between baseline levels and changes in BSDs and diagnostic changes at follow-up.
Longitudinal study of 56 patients (35 schizophrenia and 21 non-schizophrenia) recruited at their first treatment for a psychotic disorder. BSDs were assessed using the Examination of Anomalous Self-Experience (EASE), while diagnostic categories, clinical symptom severity, and functioning were assessed with standard clinical instruments.
The schizophrenia group had significantly lower levels of BSDs at follow-up compared to baseline. The EASE domain "Cognition and stream of consciousness" was the most stable. There were no diagnostic changes into or out of schizophrenia spectrum. Patients with schizophrenia had significantly higher levels of BSDs both at baseline and at follow up than patients with psychotic disorders outside the schizophrenia spectrum, who showed stable low levels.
We found a decrease and thus less stability in BSDs in schizophrenia than expected. This might indicate that BSDs tent to weaken over time, and that unknown individual characteristics may influence the development of BSDs. Diagnostic stability from baseline to follow-up may be due to long DUP before service entry.
基本的自我扰乱（BSDs）被认为是精神分裂症谱系障碍的核心特征，存在于前驱期、早期精神病和慢性期。在一些非精神分裂症谱系的精神病患者首次治疗时，也存在相当程度的 BSDs。关于自我扰乱随时间的稳定性知之甚少。
探讨首次治疗患者七年随访中 BSDs 的稳定性，以及基线水平与 BSDs 变化之间的关联以及随访时的诊断变化。
对 56 名（35 名精神分裂症和 21 名非精神分裂症）首次接受精神病治疗的患者进行纵向研究。使用异常自我体验检查（EASE）评估 BSDs，同时使用标准临床工具评估诊断类别、临床症状严重程度和功能。
与基线相比，精神分裂症组在随访时 BSDs 水平显著降低。EASE 领域“认知和意识流”最稳定。没有诊断从精神分裂症谱系内转为或转为精神分裂症谱系外。精神分裂症患者在基线和随访时的 BSDs 水平均显著高于非精神分裂症谱系的精神病患者，后者表现出稳定的低水平。
我们发现精神分裂症中的 BSDs 减少且稳定性降低，这可能表明 BSDs 随着时间的推移减弱，而未知的个体特征可能会影响 BSDs 的发展。从基线到随访的诊断稳定性可能是由于在进入服务之前有较长的 DUP。
