Formación de la identidad en la Esquizofrenia y el Trastorno Bipolar / [Identity formation in schizophrenia and bipolar disorder]

ABSTRACT

INTRODUCTION: Different authors have suggested that identity and identity formation are important concepts for the comprehension and management of psychiatric disorders. This paper seeks to demonstrate significant benefits when identity formation is analyzed from an empirical-clinical perspective. These benefits include clarification of difficult theoretical issues, delineation of specific research directions and enrichment of diagnosis and psychopathological understanding. METHOD: 45 inpatients with an acute psychotic syndrome of the Psychiatric Clinic of the University of Chile were diagnosed according to DSM IV and ICD 10 criteria. All patients were young males suffering their first psychotic episode. All of them were interviewed by the same researcher during the first week of hospitalization. 26 patients received the diagnosis of a bipolar disorder and 19 patients of a schizophreniform disorder. Patients with comorbidity on axes I, II or III of DSM-IV were excluded. A semi-standardized clinical interview focused on the content of the auditory hallucinations and premorbid social contacts was performed. The level of identity-formation was assessed according to phenomenological descriptions and E. Erikson’s development concepts. RESULTS: Patients with a schizophreniform disorder reported significant less premorbid sexual contacts as compared to bipolars, and significant more acoustic hallucinations with homosexual content. The group of patients with a schizophreniform disorder expressed more preoccupations about their own sexual identity and exhibit a lower identity development when compared with bipolar patients. DISCUSSION: Identity and the level of identity formation can be important concepts for the theoretical and clinical understanding of different psychiatric disorders. In their first psychotic episode bipolars and schizophrenic patients show significant differences when analyzed from the perspective of their identity formation. These findings can be very helpful in clinical and theoretical work on psychiatric disorders.