title: Disturbance of intentionality: a phenomenological study of body-affecting first-rank symptoms in schizophrenia.
abstract: OBJECTIVE
  In 1950, Kurt Schneider proposed that a considerable number of schizophrenia patients develop first-rank symptoms (FRS). In such cases, patients report made experiences, replaced control of will, thought insertion, broadcast or withdrawal and delusional perception, respectively. Although a number of recent studies tend to explain FRS in terms of neurobiological and neuropsychological processes, the origin of these symptoms still remains unknown. In this paper, we explore the subjective experience of patients with the following two FRS: (1) "made" impulses and (2) "made" volitional acts.
  
  
  METHODS
  The method applied for the study of two FRS consists first in the overview of psychiatric and philosophical literature and second in the further investigation of subjective experience in patients with FRS. Psychopathological and phenomenological aspects of FRS are discussed by means of patient cases.
  
  
  RESULTS
  We discovered a profound transformation of intentionality and agency in schizophrenia patients with body-affecting FRS. This concept offers an insight into the interrelatedness between particular FRS.
  
  
  CONCLUSIONS
  We propose that the subjective experience of schizophrenia patients with body-affecting FRS is rooted in the disturbance of intentionality and diminished sense of agency. This theoretical account of body-affecting FRS will open up new directions in both phenomenological and neurobiological psychiatric research.
authors.affiliation: Section Phenomenological Psychopathology and Psychotherapy, Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany ; Structural Neuroimaging Group, Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
authors.forename: Dusan
authors.initials: D
authors.lastname: Hirjak
authors.forename: Thiemo
authors.initials: T
authors.lastname: Breyer
authors.forename: Philipp Arthur
authors.initials: PA
authors.lastname: Thomann
authors.forename: Thomas
authors.initials: T
authors.lastname: Fuchs
mesh_terms: D006801:Humans; D033182:Intention; D012559:Schizophrenia / Q000503:physiopathology*; D012565:Schizophrenic Psychology
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