medigraphic.com
ISSN 0185-3325 (Print)
Órgano Oficial del Instituto Nacional de Psiquiatría Ramón de la Fuente Muńiz

2015, Number 2

<< Back Next >>

Salud Mental 2015; 38 (2)

Anomalías de la experiencia subjetiva en psicosis: Concepto y validación empírica del modelo de los Síntomas Básicos

Vilagrŕ RR, Barrantes-Vidal N

Language: Spanish
References: 51
Page: 139-146
PDF size: 322.23 Kb.


ABSTRACT

IntroductionResearch, diagnosis and treatment of psychotic spectrum disorders have been traditionally dominated by an objectivist approach to their understanding, being primarily focused on positive and negative symptoms. The value of this approach goes without question, but it also involves considerable and widely known limitations. From a complementary perspective, there is a longstanding and promising phenomenological tradition in which the subjective experience of the patient’s symptom becomes crucial. The focus on the anomalies of subjective experience, or the Basic Symptom concept specifically, has gained much momentum in the context of early detection of psychosis and schizophrenia.
Objective This review presents the phenomenological approach to the anomalies of subjective experience and the Basic Symptoms model and its empirical validation process in the field of early detection of psychosis.
Method The scientific literature was collected from PubMed Central® and PsycINFO® databases and books from authors of reference.
Results In the last two decades there has been a growing scientific interest in this approach with very promising results.
Discussion and conclusion The most prominent model from an empirical standpoint is the Basic Symptoms approach, although recently the disturbances of the flow of consciousness or self disorders have achieved great relevance as well.
It has been found that the anomalies of subjective experience could delimitate a risk profile that precedes that defined by attenuated psychotic symptoms. Therefore, this approach is a highly valuable complement in the early detection and intervention of psychosis strategies.


REFERENCES

  1. Parnas J, Handest, P. Phenomenology of anomalous self-experience in early schizophrenia. Compr Psychiatry 2003;44(2):121-134.

  2. Peralta V, Cuesta MJ. Subjective experiences in schizophrenia: A critical review. Compr Psychiatry 1994;35(3):198-204.

  3. Sass L, Parnas J. Phenomenology of self-disturbances in schizophrenia: Some research findings and directions. Philos Psychiatr Psychol 2001;8(4):347-356.

  4. Sass L. Self-disturbance and schizophrenia: Structure, specificity, pathogenesis (Current issues, New directions). Schizophr Res 2013;S0920-9964(13):272-277.

  5. Lysaker PH, Lysaker JT. Schizophrenia and alterations in self-experience: A comparison of 6 perspectives. Schizophr Bull 2010;36(2):331-340.

  6. Gross G. The “basic” symptoms of schizophrenia. Br J Psychiatry 1989;155(suppl):21-25.

  7. Gross G, Huber G. The history of the basic symptom concept. Acta Clin Croat 2010;49(2):47-59.

  8. Huber G, Gross G. The concept of basic symptoms in schizophrenic and schizoaffective psychoses. Recenti Prog Med 1989;80(12):646-652.

  9. Schultze-Lutter F, Klosterkötter J, Picker H, Steinmeyer EM et al. Predicting first-episode psychosis by Basic Symptom Criteria. J Clin Neuropsychiatry 2007;4(1):11-22.

  10. Schultze-Lutter F. Subjective Symptoms of Schizophrenia in Research and the Clinic: The Basic Symptom Concept. Schizophr Bull 2009;35(1):5-8.

  11. Pérez-Alvarez M, García-Montes J, Sass L. La hora de la fenomenología en la esquizofrenia. Clínica Salud 2010;21(3):221-233.

  12. Jimeno-Bulnes N, Jimeno-Valdés A, Vargas ML. El síndrome psicótico y el Inventario de Frankfurt: conceptos y resultados. Barcelona: Springer- Verlag Ibérica; 1996.

  13. Schultze-Lutter F, Ruhrmann S, Picker H, von Reventlow et al. Basic symptoms in early psychotic and depressive disorders. Br J Psychiatry 2007;51:31-37.

  14. Gross G. The onset of schizophrenia. Schizophr Res 1997;28:187-198.

  15. Klosterkötter J, Hellmich M, Steinmeyer EM, Schultze-Lutter F. Diagnosing schizophrenia in the initial prodromal phase. Arch Gen Psychiatry 2001;58(2):158-164.

  16. Gross G, Huber G, Klosterkötter J, Linz M. Bonner Skala für die Beurteilung von Basis-symptomen –Bonn Scale for the Assessment of Basic Symptom. Berlin: Springer; 1987.

  17. Klosterkötter J, Gross G, Huber G, Wieneke A et al. Evaluation of the Bonn Scale for the assessment of basic symptoms –BSABS– as an instrument for the assessment of schizophrenia proneness: a review of recent findings. Neurol Psychiatr Brain Res 1997;5:137-150.

  18. Schultze-Lutter F, Ruhrmann S, Klosterkötter J. Can schizophrenia be predicted phenomenologically? En: Johannessen JO, Martindale B, Cullberg J (eds.). Evolving psychosis. Different stages, different treatments. Londres, Nueva York: Routledge: 2006; pp.104-123.

  19. Schultze-Lutter F, Addington J, Ruhrmann S, Klosterkötter J. Schizophrenia Proneness Instrument –Adult version (SPI-A). Rome: Giovanni Fioriti; 2007.

  20. Schultze-Lutter F, Koch E. Schizophrenia Proneness Instrument - Child and Youth version (SPI-CY). Rome: Giovanni Fioriti; 2010.

  21. Schultze-Lutter F, Ruhrmann S, Klosterkötter J. Early detection of psychosis- establishing a service for persons at risk. Eur Psychiatry 2009;24(1):1-10.

  22. Kay SR, Fiszbein A, Opler LA. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr Bull 1987;13:261-276.

  23. Schultze-Lutter F, Ruhrmann S, Fusar-Poli P, Bechdolf A et al. Basic symptoms and the prediction of first-episode psychosis. Curr Pharm Des 2012;18(4):351-357.

  24. Schultze-Lutter F, Steinmeyer EM, Ruhrmann S, Klosterkötter J. The dimensional structure of self-reported “prodromal” disturbances in Schizophrenia. J Clin Neuropsychiatry 2008;5(3):140-150.

  25. Schimmelmann BG, Walger P, Schultze-Lutter F. The significance of At-Risk Symptoms for Psychosis in Children and Adolescents. Can J Psychiatry 2013;58(1):32-40.

  26. Cornblatt BA, Lencz T, Smith CW, Olsen R et al. Can antidepressants be used to treat the schizophrenia prodrome? Results of a prospective, naturalistic treatment study of adolescents. J Clin Psychiatry 2007; 68(4):546-557.

  27. Ziermans T, Schothorst P, Sprong M, van Engeland H. Transition and remission in adolescents at ultra-high risk for psychosis. Schizophr Res 2011;126:58-64.

  28. Meng H, Schimmelmann BG, Koch E, Bailey B et al. Basic symptoms in the general population and in psychotic and non-psychotic psychiatric adolescents. Schizophr Res 2013;111(1-3):32-38.

  29. Schultze-Lutter F, Schimmelmann BG, Koch E. The dimensional structure of prodromal symptoms in early-onset psychosis: Indication of special needs in the early detection of younger adolescents. Schizophr Res 2010;117:2-3.

  30. Fux L, Walger P, Schimmelmann BG, Schultze-Lutter F. The Schizophrenia proneness instrument, child and youth version (SPI-CY): Practicability and discriminative validity. Schizophr Res 2013;146:69- 78.

  31. Koch E, Schultze-Lutter F, Schimmelmann BG, Resch F. On the importance and detection of prodromal symptoms from the perspective of child and adolescent psychiatry. J Clin Neuropsychiatry 2010;2:38- 48.

  32. McGorry PD, Nelson B, Amminger GP, Francey SM et al. Intervention in individuals at ultra-high risk for psychosis: a review and future directions. J Clin Psychiatry 2009;70(9):1206-1212.

  33. Yung AR, McGorry PD, McFarlane CA, Jackson, HJ et al. “Monitoring and care of young people at incipient risk of psychosis”. Schizophr Bull 1996;22(2):283-303.

  34. Cornblatt BA, Lencz T, Smith CW, Correll CU et al. The schizophrenia prodrome revisited: a neurodevelopmental perspective. Schizophr Bull 2003;29(4):633-651.

  35. Yung AR, Yuen HP, McGorry PD, Phillips LJ et al. Mapping the onset of psychosis: the Comprehensive Assessment of At-Risk Mental States. Aust N Z J Psychiatry 2005;39(11-12):964-971.

  36. McGlashan T, Walsh B, Woods S. The Psychosis-Risk Syndrome. Handbook for diagnosis and follow-up. Oxford: University Press; 2010.

  37. Klosterkotter J, Schultze-Lutter F, Bechdolf A, Ruhrmann S. Prediction and prevention of schizophrenia: what has been achieved and where to go next? World Psychiatry 2011;10(3):165-174.

  38. Schultze-Lutter F, Ruhrmann S, Berning J, Maier W et al. Basic symptoms and ultrahigh risk criteria: Symptom development in the initial prodromal state. Schizophr Bull 2008;36(1):182-191.

  39. Simon AE, Dvorsky DN, Boesch J, Roth B et al. Defining subjects at risk for psychosis: A comparison of two approaches. Schizophr Res 2006;81:83-90.

  40. Fusar-Poli P, Borgwardt S, Valmaggia L. Heterogeneity in the assessment of the at-risk mental state for psychosis. Psychiatr Serv 2008;59(7):813.

  41. Domínguez-Martínez T, Blanqué JM, Codina J, Montoro M et al. Rationale and state of the art in early detection and intervention in psychosis. Salud Mental 2011;34(4):341-350.

  42. Domínguez-Martínez T, Vainer E, Massanet MA, Torices I et al. The need-adapted integrated treatment in Sant Pere Claver-Early Psychosis Program (SPC-EPP) in Barcelona, Spain. Salud Mental 2011;34(6):517-524.

  43. Ruhrmann S, Schultze-Lutter F, Salokangas RKR, Heinimaa M et al. Prediction of psychosis in adolescents and young adults at high risk: results from the prospective European prediction of psychosis study. Arch Gen Psychiatry 2010;67 (3):241-251.

  44. Velthorst E, Nieman DH, Becker HE, van de Fliert et al. Baseline differences in clinical symptomatology between ultra high risk subjects with and without a transition to psychosis. Schizophr Res 2009;109(1-3):60-65.

  45. Häfner H, Löffler W, Maurer K, Hambrecht M et al. Depressión, negative symptoms, social stagnation and social decline in the early course of schizophrenia. Acta Psychiatr Scand 1999;100(2):105-118.

  46. Parnas J, Handest P, Saebye D, Janson L. Anomalies of subjective experience in Schizophrenia and psychotic bipolar illness. Acta Psychiatr Scand 2003;108:126-133.

  47. Raballo A, Sćbye D, Parnas J. Looking at the schizophrenia spectrum through the prism of self-disorders: an empirical study. Schizophr Bull 2011;37(2):344-351.

  48. Parnas J, Raballo A, Handest P, Janson L et al. Self-experience in the early phases of schizophrenia: 5-year follow-up of the Copenhagen Prodromal Study. World Psychiatry 2011;10(3):200-204.

  49. Parnas J, Mřller P, Kircher T, Thalbitzer J et al. EASE: Examination of anomalous self-experience. Psychopathology 2005;38(5):236-258.

  50. Nelson B, Thompson A, Yung R. Basic self-disturbance predicts psychosis onset in the ultra high risk for psychosis “prodromal” population. Schizophr Bull 2012;38 (6):1277-1287.

  51. Koren D, Reznik N, Adres M, Scheyer R et al. Disturbances of basic self and prodromal symptoms among non-psychotic help-seeking adolescents. Psychol Med 2013;43(7):1365-3176.




2020     |     www.medigraphic.com