Centro Hospitalar Universitário de Lisboa Norte, Psychiatry Department, Lisbon, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal. Electronic address: luismadeiramd@gmail.com.
2 papers in the library · 21 citations · publishing 2019-2025
People with first-episode psychosis often experience profound changes in how they perceive the world around them—including alterations in space, time, and other people—alongside disturbances in their sense of self. In a study comparing 24 outpatients with first-episode psychosis to 24 healthy controls, those with psychosis scored significantly higher on both the Examination of Anomalous World Experience (EAWE) and the Examination of Anomalous Self Experience (EASE). Scores on the two measures were strongly correlated, even after accounting for overlapping items. The types of world-experience anomalies varied widely among patients. These findings suggest that anomalous world experiences are a relevant feature of first-episode psychosis and may be linked to the self-disturbances thought to underlie schizophrenia spectrum disorders.
Psychopharmacology is often reduced to treating biological symptoms while ignoring patients' subjective, embodied experience. This paper proposes an enactive and embodied framework that integrates phenomenology, neuroscience, and physiology to understand how psychotropic drugs affect the entire lived body—altering emotional processing, perception, existential feelings, and the embodied sense of self. Medications shape how patients engage with their environment, which in turn influences the embodied system. The clinician's role is to mediate these embodied changes, supporting patients through shifts in self-perception and relationality. The authors advocate for phenomenological drug profiles and patient-centered interventions that account for subjective and embodied changes alongside clinical efficacy.