Raballo Andrea, Poletti Michele, Bevione Francesco, Lacidogna Maria Carla, Preti Antonio
Chair of Psychiatry, Faculty of Biomedical Sciences, University of Southern Switzerland, Lugano, Switzerland.
Cantonal Sociopsychiatric Organisation, Mendrisio, Switzerland.
Schizophr Bull. 2025 May 8;51(3):578-594. doi: 10.1093/schbul/sbae159.
Subtle distortions of the experience of lived space have long been associated with schizophrenia. Although a body-centric transformation of space is considered an essential component of anomalous subjective experience in schizophrenia, its impact on the 2 major body-centric spatial constructs, that is, personal space (PS) and peripersonal space (PPS), is still not clear. This systematic review and meta-analysis have been set up to: (1) summarize the evidence on putative extensional differences of PS and PPS in schizophrenia as compared with controls, and (2) evaluate the quality and the limitations of available studies on the topic. Four electronic literature databases (MEDLINE, EMBASE, PsychINFO, and CINAHL) were searched with the keywords "Personal space OR Interpersonal distance AND Schizophrenia," "Peripersonal space AND Schizophrenia" from inception until December 31, 2023, resulting in 15 studies on PS and 5 studies on PPS included in this systematic review. The 12 studies on PS included in the meta-analysis revealed that individuals with a diagnosis of schizophrenia place a larger interpersonal distance from the stimuli than controls, with a moderate effect size in both the fixed-effect model (Hedges' g = 0.558 [95% confidence interval, CI: 0.445-0.671]; z = 9.67; P < 0.0001) and the random effects model (0.547 [0.294-0.799]; z = 4.77; P = 0.0006). The 5 studies included in the meta-analysis on PPS showed that individuals with a diagnosis of schizophrenia exhibit a narrower PPS than the controls at the fixed-effect (Hedges' g = 1.043 [95%CI: .739-1.348]; z = 6.72; P < .0001), but not at the random effects model (1.318 [-0.721 to 3.359]; z = 1.79; P = .147). Heterogeneity was substantial in both meta-analyses. Overall, the findings indicate that both body-centered space constructs (PS and PPS) are affected in schizophrenia, with an enlargement PS and a reduction PPS, thereby supporting the distinction of these constructs. These modifications cohere with the subjective transformation of the lived space (aka espace vécu) reported in classical psychopathology and may be promising, neurodevelopmentally grounded, biomarkers of vulnerability to schizophrenia and its spectrum conditions.
长期以来，生活空间体验的细微扭曲一直与精神分裂症相关。尽管以身体为中心的空间转换被认为是精神分裂症异常主观体验的一个重要组成部分，但其对两个主要的以身体为中心的空间结构，即个人空间（PS）和周边个人空间（PPS）的影响仍不明确。本系统评价和荟萃分析旨在：（1）总结与对照组相比，精神分裂症患者PS和PPS假定的外延差异的证据；（2）评估该主题现有研究的质量和局限性。使用关键词“个人空间或人际距离与精神分裂症”“周边个人空间与精神分裂症”检索了四个电子文献数据库（MEDLINE、EMBASE、PsychINFO和CINAHL），检索时间从数据库建立至2023年12月31日，结果有15项关于PS的研究和5项关于PPS 的研究纳入本系统评价。纳入荟萃分析的12项关于PS的研究表明，被诊断为精神分裂症的个体与刺激物之间的人际距离比对照组更大，在固定效应模型（Hedges' g = 0.558 [95%置信区间，CI：0.445 - 0.671]；z = 9.67；P < 0.0001）和随机效应模型（0.547 [0.294 - 0.799]；z = 4.77；P = 0.0006）中效应量均为中等。纳入PPS荟萃分析的5项研究表明，在固定效应模型中，被诊断为精神分裂症的个体的PPS比对照组更窄（Hedges' g = 1.043 [95%CI：0.739 - 1.348]；z = 6.72；P < 0.0001），但在随机效应模型中并非如此（1.318 [-0.721至3.359]；z = 1.79；P = 0.147）。两项荟萃分析中的异质性都很大。总体而言，研究结果表明，精神分裂症患者的两个以身体为中心的空间结构（PS和PPS）均受到影响，PS增大而PPS减小，从而支持了这些结构的区别。这些改变与经典精神病理学中报道的生活空间（即生存空间）的主观转变相一致，可能是有前景的、基于神经发育的精神分裂症及其谱系障碍易感性生物标志物。
