From experience to symptoms: a multilayer hierarchy of psychopathological dimensions in schizophrenia.

Abstract

Introduction The psychopathology of schizophrenia is a complex amalgamation of features that span across different dimensions. These dimensions range from the experience of altered time and space through self-disorders to perceptual, positive and negative symptoms. The relationship between these different psychopathological dimensions remains unclear. Addressing this gap is the aim of our study. Methods We collected data on schizophrenia spectrum disorder at three medical expert centers, via semi-structured phenomenological interviews, consisting of the Scale for Space and Time Experience in Psychosis (STEP), the Positive and Negative Syndrome Scale for Schizophrenia (PANSS) and, for a subset of this data, the Examination of Anomalous Self Experience (EASE) and the perceptual domain of the Bonn Scale for the Assessment of Basic Symptoms (BSABS; or BONN). Various state of the art statistical methods including network and mediation analyses were used to investigate the relationships between these psychopathological dimensions. Results We found a relationship between altered time and space experiences (STEP) and both general symptoms (PANSS) and the basic self-disorders (EASE). Conclusion Our various network and mediation analyses show that the basic self-disturbance is a key node in mediating the impact of the more fundamental time and space disturbances on both perceptual changes, and negative, positive and general symptoms.