Understanding ‘self-disturbance’ in schizophrenia to help patients effectively

Alongside treating symptoms with medication and psychotherapy, experts are of the say that a better understanding of the experience of people with schizophrenia would enable clinicians to help patients effectively. According to the experts at the University of Birmingham, this approach would involve developing an understanding of ‘self-disturbance’ in schizophrenia - in which patients’ sense of connection to themselves and to their actions is disrupted.

Published in The Lancet Psychiatry, the team of researchers assessed existing theories around how this sense of self is constructed by schizophrenia patients. The developed theories explore the ways in which patients might feel their thoughts do not belong to them or the irregularities in the way people with schizophrenia might perceive the world.

Dr Clara Humpston, the co-lead author of the study, explained: “Clinical intervention frequently focuses on correcting the patient’s thoughts and perceptions. We think this effort is misplaced. Instead, well-informed clinicians might focus on how patients can lead a fulfilling life with their symptoms.”

Humpston acknowledged that the key to this is to admit what we consider to be ‘real’ is likely to be different fro the clinician and the patient.

This conflict is likely to be particularly pronounced in the early stages of the illness where patients are likely to show a lack of insight into their behaviour or the condition itself.

“However, ‘reality’ is still constructed by similar neural and experiential mechanisms for both clinician and patient. Clinicians must not forget how they approach the discrepancies, in reality, can make a lasting impact on the patients’ willingness to engage as it’s often in the early stages of an illness that intervention can be most successful,” Dr Humpston said.

Dr Humpston further said: “This sort of approach requires clinicians to listen more carefully with an open mind, putting aside what they would interpret as ‘real’. With this understanding, clinicians are better able to engage with the patient, share clinical knowledge and come to a mutually understood plan for care and recovery.”

(This story has been published from a wire agency feed without modifications to the text. Only the headline has been changed.)

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