Psychopathology of Lived Time: Abnormal Time Experience in Persons With Schizophrenia.
Abnormal time experience (ATE) in schizophrenia is a long-standing theme of phenomenological psychopathology. This is because temporality constitutes the bedrock of any experience and its integrity is fundamental for the sense of coherence and continuity of selfhood and personal identity. To characterize ATE in schizophrenia patients as compared to major depressives we interviewed, in a clinical setting over a period of 15 years, 550 consecutive patients affected by schizophrenic and affective disorders. Clinical files were analyzed by means of Consensual Qualitative Research (CQR), an inductive method suited to research that requires rich descriptions of inner experiences. Of the whole sample, 109 persons affected by schizophrenic (n = 95 acute, n = 14 chronic) and 37 by major depression reported at least 1 ATE. ATE are more represented in acute (N = 109 out of 198; 55%) than in chronic schizophrenic patients (N = 14 out of 103; 13%). The main feature of ATE in people with schizophrenia is the fragmentation of time experience (71 out of 109 patients), an impairment of the automatic and prereflexive synthesis of primal impression-retention-protention. This includes 4 subcategories: disruption of time flowing, déjà vu/vecu, premonitions about oneself and the external world. We contrasted ATE in schizophrenia and in major depression, finding relevant differences: in major depressives there is no disarticulation of time experience, rather timelessness because time lacks duration, not articulation. These core features of the schizophrenic pheno-phenotype may be related to self-disorders and to the manifold of characteristic schizophrenic symptoms, including so called bizarre delusions and verbal-acoustic hallucinations.
Department of Psychological, Humanistic and Territorial Sciences, University "G. D' Annunzio", Chieti, Italy; Centro de Estudios de Fenomenología y Psiquiatría, Universidad "Diego Portales", Santiago, Chile; giostan@libero.it.
Giovanni
G
Stanghellini
Department of Mental Health, Local Health Authority, Florence, Italy;
Massimo
M
Ballerini
Department of Psychological, Humanistic and Territorial Sciences, University "G. D' Annunzio", Chieti, Italy;
Simona
S
Presenza
Department of Psychological, Humanistic and Territorial Sciences, University "G. D' Annunzio", Chieti, Italy;
Milena
M
Mancini
Department of Mental Health and Pathological Addiction, Local Health Authority, Reggio Emilia, Italy;
Andrea
A
Raballo
Department of Human Science, Carlo Bo University of Urbino, Urbino, Italy;
Stefano
S
Blasi
Institute of Psychiatry, Kings College Hospital, London, UK.
John
J
Cutting
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015331:Cohort Studies; D003690:Deja Vu / Q000523:psychology; D003865:Major Depressive Disorder / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010469:Perceptual Distortion; D036301:Qualitative Research; D012189:Retrospective Studies; D012559:Schizophrenia / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D012649:Self Concept; D060685:Sense of Coherence; D013998:Time Perception; D055815:Young Adult
Pheno-phenotype; qualitative method; recovery model; schizophrenia; self-disorders; temporality