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Psych J. 2015 Dec;4(4):186-98. doi: 10.1002/pchj.115. Epub 2015 Nov 16.

A disembodied man: A case of somatopsychic depersonalization in schizotypal disorder.

Author information

1
Department of National IT System of Mental Health and Brain Monitoring, National Institute of Mental Health, Klecany, Czech Republic.
2
Department of Psychiatry and Medical Psychology, 3rd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
3
Human Science Centre and Institute of Medical Psychology, Ludwig-Maximilian University, Munich, Germany.
4
Outpatient Psychiatry and Organization for Psychiatric Care, Moscow Research Institute of Psychiatry, Moscow, Russia.
5
Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany.
6
Institute of Practical Psychology and Psychoanalysis, Moscow, Russia.
7
National Research University, Higher School of Economics, Moscow, Russia.
8
Institute for Frontier Areas of Psychology and Mental Health, Freiburg, Germany.

Abstract

In the general concept of self-disturbances in schizophrenia and schizophrenia spectrum disorders, somatopsychic depersonalization (SPD) occupies a special place as it constitutes a syndrome that comprises feelings of detachment from one's own body and mental processes. However, apart from clinical descriptions, to date the pathophysiology of SPD is not fully understood due to the rareness of the syndrome and a lack of experimental studies. In a case study of one patient with schizotypal disorder, we applied a multimodal approach to understanding the SPD phenomena. The patient's clinical profile was identified as disruption of implicit bodily function, accompanied by depressive symptoms. On a neuropsychological level, the patient exhibited impairment in executive functioning, intact tactile perception and kinesthetic praxis. Behavioral tests revealed an altered sense of time but unimpaired self-agency. Furthermore, the patient exhibited a lack of empathy and he had autistic traits, although with a sufficient ability to verbalize his feelings. On the neurobiological level using an active and passive touch paradigm during functional magnetic resonance imaging (fMRI), we found a hyperconnectivity of the default-mode network and salience network and a hypoconnectivity of the central executive brain networks in the performance of the touch task as well as intact perceptual touch processing emerging from the direct comparisons of the touch conditions. Our data provide evidence for the important role of altered large-brain network functioning in SPD that corresponds to the specific behavioral and neurocognitive phenomena.

KEYWORDS:

disembodiment; fMRI; neurocognition; schizotypal disorder; self; somatopsychic depersonalization; time perception; touch

PMID:
26571072
DOI:
10.1002/pchj.115
[Indexed for MEDLINE]

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