[Psychopathological study of hypochondriaco-cenestopathic symptoms in schizophrenia]

There is evidence that the psychiatric importance of hypochondriacal or cenestopathic symptoms in schizophrenia is prone to be neglected, in so far as these symptoms are expressed through the discourse of somatic medicine. Psychopathological studies of these symptoms are few as compared to studies of other schizophrenic symptoms such as delusion or verbal acoustic hallucination. However, it could be said that such study is indispensable in developing both an understanding of schizophrenics and therapeutic strategies for the treatment of them, in so far as hypochondriaco-cenestopathic symptoms directly indicate a pathology of body-consciousness in schizophrenia. Motivated by these practical as well as theoretical demands, the author presents first of all statistical characteristics of hypochondriaco-cenestopathic symptoms based on a longitudinal study of 183 schizophrenic patients, who were observed for at least 5 years. All the patients satisfied the DSM-III-R criteria for schizophrenia. Taking into consideration these statistical characteristics, as well as certain detailed representative cases, the author proposes a new psychopathological perspective of the hypochondriaco-cenestopathic symptoms in schizophrenia. The essential result of this statistical investigation is summarized as follows. 81 schizophrenic patients exhibited the hypochondriaco-cenestopathic symptoms, accounting for 44.3% of the sample. If we exclude the cases which presented physical experience of being influenced (physikalische Beeinflussungserlebnis), appearance frequency of hypochondriaco-cenestopathic symptoms accounted for 27.9% of the sample. Among the manifestations of these symptoms, uncharacteristic somatic complaint was the most frequent. Here, the most common was pain of body (especially headaches). The second most common was complaint of easy fatigability. Concerning the appearance pattern of the symptom, we found no significant difference between the acute and chronic types, nor between the early and tardive types, while the complex type was significantly more frequent in comparison with the simple type. Among the other symptoms that co-occurred with the hypochondriaco-cenestopathic symptom, the most common was acoustic hallucination, whose frequency was highly statistically significant when compared to the non hypochondriaco-cenestopathic group. Regarding the relationship of the hypochondriaco-cenestopathic symptom with the subtypes of schizophrenia, the proportion of the paranoid type was significantly high in the non hypochondriaco-cenestopathic group.