About the project
The main aim of the study is to contribute to the understanding of self-disorders in the early years of treatment for psychotic disorders.
Objectives
• The extent to which self-disorders are stable phenomena over time and to what extent the level of self-disorders at baseline can predict clinical and diagnostic changes at follow-up.
• The extent to which there is a relationship between self-disorders (both at baseline and follow-up) and objective measures of mental health related to specific criteria for recovery.
• The extent to which a relationship exists between self-disorders and “Sense of Coherence”.
• Whether there are associations between neurocognitive functioning at the onset of treatment for schizophrenia and self-disorders seven years later, neurocognitive functioning and self-disorders at the follow-up time point, and whether neurocognitive functioning at the onset of treatment is related to changes in self-disorders over seven years.
• The relationship between self-disorders and neurocognition over time.
Outcomes
This study suggests that self-disorders may be less stable than initially assumed in individuals with schizophrenia. The study also reveals that low levels of self-disorders early in the course of the illness increase the chances of achieving recovery (absence of psychosis symptoms and good social/occupational functioning) seven years after the onset of psychotic disorder. Additionally, low self-disorder levels enhance the ability to experience the world as comprehensible, manageable, and meaningful (Sense of Coherence). The study also shows that poorer executive functions early during the illness were significantly associated with more self-disorders seven years later and less reduction over time. There were no significant associations found between other neurocognitive functions and self-disorders.
Further results from the study will be reported.
Background
The study is a seven-year follow-up of a study of young patients (median age 22 years) recruited in their first treatment for a psychotic disorder at Innlandet Hospital Trust from 01.01.08-01.01.10. Fifty-six (62%) of the original 90 patients participated in this study, including 35 patients with a disorder in the schizophrenia spectrum and 21 patients with a psychotic disorder outside the schizophrenia spectrum. At baseline and follow-up, participants underwent extensive diagnostic and clinical evaluation.
Sub-projects
The baseline study was Elisabeth Haug's PhD study at Innlandet Hospital, "Can self-experience assessment improve diagnosis in first-episode psychosis?". The study aimed to improve diagnostic precision and validity in the early stages of psychotic disorders by investigating whether there were differences in self-disorders (SD) in schizophrenia and bipolar disorders. The study included patients referred to first treatment for a psychotic disorder. It used the manual Examination of Anomalous Self-Experience (EASE) to assess SD, in addition to a comprehensive neuropsychological test battery and the clinical assessment battery used in the TOP study group.
Eight papers from this subproject were published.
Financing
The follow-up study is funded by PhD funds from Innlandet Hospital and some funds from the Health South-East, Regional Network for Psychosis Research.
Collaboration
Professor Barnaby Nelson at the University of Melbourne, Australia.
Involved research groups
Research group for psychosis, Innlandet Hospital
Tools
Self-disorders were assessed using the Examination of Anomalous Self-Experience (EASE) assessment tool. The study also examines possible correlations between the degree of self-disorders at baseline and recovery. The "Remission in Schizophrenia Working Group" (RSWG) criteria (N. Andreasson et al.) are used for this purpose. Additionally, the relationship between the degree of self-disorders and the sense of coherence (Antonovsky's Sense of Coherence) at follow-up is investigated. Furthermore, associations between neurocognitive functioning measured with a neuropsychological test battery and self-disorders are explored.