Different facets of schizophrenia illustrated by the analysis of the homes of three patients diagnosed with schizophrenia.

Diagnosis and observation of patients' behaviour during outpatient visits or hospitalisations strips the diagnostic process of the opportunity to consider their places of residence as their natural environment. In this way, patients present their symptoms and problems outside of the context of their daily life. Community-based psychiatric care, on the other hand, provides a chance to include, in the diagnostic process the environment created by a patient in their home. This image of a patient's external reality can reflect a certain mental reality. Such elements as furniture and other objects, their number, quality, distribution may reflect the inner mental world of the objects featuring in a person's mind. In some cases, this can become a valuable contribution to a diagnostic process. A description of three patients, all treated for schizophrenia, has been presented in this paper in order to explore this possible relationship. The first individual, "Patient N" lives in a flat in a state of extreme depletion of elements. "Patient N" suffers from chronic schizophrenia with severe negative symptoms. The second individual, "Patient D", has been also diagnosed with schizophrenia. Yet his home is filled with a huge number of elements, writings on the wall, things, figurines and objects of symbolic meaning. A closer examination of his psychopathological symptoms (fantastic, colourful, bizarre content) and history of his illness (unstable diagnosis of schizophrenia), and unpredictable response to antipsychotics may indicate a dissociative type of schizophrenia. Finally, "Patient K's" main living space is dominated by cats that live with him. Patient K was exposed to physical violence as a child and to him cats represent safe, non-threatening objects. He has been also treated for paranoid schizophrenia. The differences between these patients' personal histories and the courses of their illnesses are clearly manifested in the way they create their immediate environment.

[Intensification of interpersonal sense of guilt in patients with schizophrenia]. / Nasilenie interpersonalnego poczucia winy w schizofrenii paranoidalnej.

AIM: The article presented results of a research designed to compare the feeling of guilt in healthy adults and in persons diagnosed with paranoid schizophrenia. METHOD: One hundred people diagnosed with paranoid schizophrenia participated in the research and 100 people without diagnosed psychopathology (control group). RESULTS: The findings of the research showed that the persons from the clinical group obtained much higher results in all the tests measuring a sense of guilt and that interpersonal guilt in persons suffering from paranoid schizophrenia in a majority of cases significantly is not correlated with clinical symptoms - thus it can be assessed in a relatively independent manner from a patient's behaviour and cognitive state. However, it has been proved that the strongest indications of positive symptoms of schizophrenia are: Sense of guilt related to helplessness (IGQ), Sense of guilt related to induced self-hate (IGQ), Guilt as a state (GI) and Guilt as a feature (GI), whereas indicators of negative symptoms and a general result--Guilt as a state (GI). CONCLUSION: One might suppose that such a pattern of results indicates the primacy of a characteristic (guilt as a characteristic according to the Inventory of a Sense of Guilt), which is proved by a lack of correlation between schizophrenia symptoms (being more of a state nature) and the most important dimensions of the sense of guilt (being more of a characteristic nature). Moreover, the research results give grounds to confirm the existence of significant differences in the intensity of the experienced sense of guilt (Guilt as a state and Sense of guilt related to induced self-hate guilt) among outpatients and all-day treatment patients.