Self-Disorders and Clinical High Risk for Psychosis: An Empirical Study in Help-Seeking Youth Attending Community Mental Health Facilities

• Published in: Schizophrenia bulletin Vol. 42; no. 4; pp. 926 - 932
• Main Authors: Raballo, Andrea, Pappagallo, Elena, Dell’ Erba, Alice, Lo Cascio, Nella, Patane’, Martina, Gebhardt, Eva, Boldrini, Tommaso, Terzariol, Laura, Angelone, Massimiliano, Trisolini, Alberto, Girardi, Paolo, Fiori Nastro, Paolo
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 01.07.2016
• Subjects: Adolescent; Adult; Community Mental Health Services; Female; Humans; Male; Mental Disorders - complications; Mental Disorders - physiopathology; Patient Acceptance of Health Care; Perceptual Disorders - etiology; Perceptual Disorders - physiopathology; Prodromal Symptoms; Psychotic Disorders - complications; Psychotic Disorders - physiopathology; Regular; Schizophrenia - complications; Schizophrenia - physiopathology; Young Adult; positive symptoms; clinical high risk; prodrome; basic symptoms; self; subjective experience; psychosis
• ISSN: 0586-7614; 1745-1701
• DOI: 10.1093/schbul/sbv223

Anomalous subjective experiences involving an alteration of the basic sense of self (ie, Self-disorder [SD]) are emerging as a core marker of schizophrenia spectrum disorders with potential impact on current early detection strategies as well. In this study, we wished to field-test the prevalence of SD in a clinical sample of adolescent/young adult help-seekers at putative risk for psychosis attending standard community mental health facilities in Italy. Participants (n = 47), aged between 14 and 25, underwent extensive psychopathological evaluations with current semi-structured tools to assess Clinical High Risk (CHR) state (ie, Structured Interview for Prodromal Syndromes/Scale of Prodromal Symptoms [SIPS/SOPS], Schizophrenia Proneness Instrument-Adult/Child and Youth [SPI-A/CY]). SD aggregated in CHR subjects as compared to the non-CHR and revealed substantial association with sub-psychotic symptoms (SIPS), subjective experience of cognitive and cognitive-perceptual vulnerability (basic symptoms) and functional level (Global Assessment of functioning). Moreover, a combination of the 2 approaches (ie, CHR plus SD) enabled further "closing-in" on a subgroup of CHR with lower global functioning. The results confirm SD's relevance for the early profiling of youths at potential high risk for psychosis.