Praecox feeling among Polish psychiatrists: a grounded theory study

The study aims to identify the sources and components of the so-called praecox feeling (PF) from the perspective of Polish psychiatrists who experience it and can verbalize it.

Qualitative analysis based on the grounded theory method, conducted on a set of open-ended statements provided by psychiatrists (N = 103) who described their feelings strongly suggestive of a diagnosis of schizophrenia in a nationwide survey.

For most respondents (80.58%) PF stems from patients' behaviors and states but none of the identified PF components dominate clearly over others. Physicians referred most often (44.66%) to the patients' affect and emotional states, particularly shallowness and emotional coldness (22.33%). One in four (25.24%) referred to the patients' utterances, including incoherence and detachment of content from reality (14.56%), and indicated formal disorders of mental processes (22.33%). A post-hoc analysis showed that the main cross-sectional topic of the PF was the feeling of patients' separation from the surrounding reality and other persons (raised by 52.42% of respondents). The level of psychiatric expertise does not affect PF's contents. Physicians who can verbalize it consider it reliable for diagnosing schizophrenia more often than those who use PF in their practice but cannot verbalize it (82.52% vs. 67.62%, chi2 p = 0.007, φc = 0.186).

PF is a complex and ambiguous phenomenon experienced by residents and specialists alike. It has mostly to do with affectivity and perceived detachment from reality. Further analysis may positively influence the ability of psychiatrists to articulate and apply PF in the diagnosis of schizophrenia.