[Two cases of schizophrenia presenting with 'solar experience': the 'polysolar experience' and its progression]

The 'solar experience' as an abnormal experience of schizophrenia in which patients directly experience the sun itself was first described by Miyamoto in 1974. Patients have delusions of the sun dying, hallucinations of the sun, and even believe that they become the sun. The patient may draw pictures of the sun similar to Edvard Munch's famous painting "The Sun". Miyamoto explained the progression of the solar experience as follows: (1) in the early stage of schizophrenia, patients believe that the sun falls or dies; (2) in the midst of the illness, they occupy the position of the sun in their delusions; and (3) in the recovery stage, they see or draw the sun against a scenic background, indicating that they no longer perceive themselves to be at the center of the world. Because of the absolute centrality of the sun, Miyamoto noted that the patient never experiences multiple suns (a 'polysolar experience'). However, in his book Memoirs of My Nervous Illness (original German title: Denkwürdigkeiten eines Nervenkranken), Daniel Paul Schreber described that he saw two suns. In this paper, the authors report two patients with schizophrenia who presented with a solar experience. Patient 1 was a man in his early forties. Fourteen years before his 'polysolar experience', he had attempted suicide, developed stupor, and was diagnosed with depression. However, he sometimes exhibited cenestopathy. Three years before the experience, he developed catatonic stupor and auditory hallucinations, and his diagnosis was changed to schizophrenia. After two months of hospitalization, the patient, in partial remission, was discharged. Ten months later, he saw two fragments tumble down from the sun, which he described as sons of the sun. Thereafter, his behavior became erratic, which led to a third hospitalization. In the recovery phase, the patient drew a picture of a large sun covering the entire piece of drawing paper and another of the sun set in scenery. Patient 2 was a married woman in her late thirties. She developed delusions of persecution during high school. She managed to cope with the delusions over the next several years, until she experienced an acute psychotic episode while studying in an Asian country. After returning to Japan, she began treatment for schizophrenia. Her first marriage failed, and she later experienced marital problems in her second marriage. She hoped that having a baby would solve these problems, but neuroleptic-induced hyperprolactinemia made her infertile. She stopped taking the neuroleptics and had delusions, including that she was loved by the Crown Prince of Japan and that they would be married, and that her husband was an imposter and assassin. During a 4-month period of hospitalization, she repeatedly drew pictures of multiple suns. In the recovery phase, she drew the sun set in scenery but assigned it a specific area set apart from the rest of the picture. The solar experience of Patient 1 follows a relatively typical course which Miyamoto schematized. The patient's experience of a fragmented sun is equivalent to the fall or death of the sun, and was thought to occur in the transition between the first and second stages of the progression of the solar experience. The polysolar drawings of Patient 2 were also produced in the period between the first and second stages, where the multiple suns might signify the patient's ideal partner among many imposters.