Het veronachtzaamde ‘zelf’ bij schizofrenie

BACKGROUND: Although self-disorders are common in schizophrenia, little attention is paid to them in clinical practice. AIM: To provide an overview of the knowledge regarding self-disorders in schizophrenia in the context of diagnosis and treatment. METHOD: A description of the literature on the history, background, diagnosis and treatment of self-disorders in schizophrenia. RESULTS: From a phenomenological perspective, disturbances in the minimal self frequently occur in schizophrenia. Two self-disorders are described: decreased self-affection (reduced sense of ownership of experiences, reduced sense of authorship of actions) and hyperreflexivity (normally self-evident experiences receive disproportionate attention). Self-disorders are common in schizophrenia, but also in other psychiatric classifications. Partly due to the emphasis on reliability of DSM-5 classifications, there is limited interest in the self-disorders. Treatment focused on physical and social activity can probably enhance the basic sense of self. In addition, hyperreflexivity may be reduced by interventions aimed at acceptance, while targeting so-called erroneous cognitions may possibly worsen hyperreflexivity. CONCLUSION: Self-disorders in schizophrenia are common and insufficient attention is paid to self-disorders in research and clinical practice. More knowledge about self-disorders might lead to new insights into therapeutic options in schizophrenia.