Body image, symptoms and insight in chronic schizophrenia

Historically, schizophrenics' body image problems were regarded as related particularly to delusions and hallucinations. However, during the 1980s, the predominant view of the phenomenology of the disorder broadened to include negative symptoms; deviations in schizophrenics' body image underlie various behaviors or allegations concerning the body and should be refocused. The present study attempted to detect body image deviations in chronic schizophrenia using the Body Image Questionnaire (BIQ), which comprises three hypothetical components (anatomical, functional and other psychological components), and to clarify their related clinical characteristics in symptoms and insight. The BIQ was administered to 93 chronic schizophrenics (diagnosed according to DSM IV; 44 men and 49 women) and 177 normals (78 men and 99 women) adults. The combined data of the three BIQ components in schizophrenic and normal subjects were factor-analyzed separately, and factor scores obtained were compared between schizophrenic and normal groups. The factor scores that differentiated groups were further compared between schizophrenic subgroups, determined by high or low scores for positive symptoms assessed by Scale for the Assessment of Positive Symptoms, negative symptoms by Scale for the Assessment of Negative Symptoms and insight by the Schedule for Assessing Insight. Significant differences between diagnostic groups were found in five of nine factor scores. Dullness in movement, powerlessness, unusually strong gastrointestinal function, lifelessness and fragility proved to be the deviated body images in chronic schizophrenic patients. Powerlessness and lifelessness proved to be related to positive and negative symptoms, and unusually strong gastrointestinal function and fragility to insight.