Basic self-disturbances are associated with sense of coherence in patients with psychotic disorders

Background: The Sense of Coherence (SOC) theory gives a possible explanation of how people can experience subjective good health despite severe illness. Basic self-disturbances (BSDs) are subtle non-psychotic disturbances that may destabilize the person’s sense of self, identity, corporeality, and the overall ‘grip’ of the world.

Aim:  Our objective was to investigate associations between BSDs and SOC in patients with psychotic disorders.

Design: This is a cross-sectional study of 56 patients diagnosed with psychotic disorders inside and outside the schizophrenia spectrum (35 schizophrenia, 13 bipolar, and eight other psychoses).  SOC was measured using Antonovsky’s 13-item SOC questionnaire, and BSDs were assessed using the Examination of Anomalous Self-Experience (EASE) manual.  Diagnosis, symptoms, and social and occupational performance were assessed using standardized clinical instruments.

Results: We found a statistically significant correlation (r=) between high levels of BSDs and low levels of SOC (r=-0.64/p<0.001).  This association was not influenced by diagnostics, clinical symptoms or level of functioning in follow-up multivariate analyses.

Conclusion: A statistically significant association between BSDs and SOC indicates that the presence and level of self-disturbances may influence the person's ability to experience life as comprehensive, manageable and meaningful. However, the cross-sectional nature of the study precludes conclusions regarding the direction of this association. 

Methods
Cross-sectional study, Structured and semistructured interviews, and self-reports