Conscience de soi et conscience de la maladie dans la schizophrénie : relations avec l’anxiété et la dépression

Elevated rates of suicide in schizophrenia lead us to think that a lot of patients can’t cope with such a frightening, disorganizing or apragmatic experience. In contrast, we insist about the frequency of unawareness of illness as a characteristic of the schizophrenic patient, with paradoxically litlle or no effect on suicidal behaviour. Our study tended to precise the links between awareness of illness, anxiety and depression. We also rated self-consciousness, to see if this tendency could be correlated with other variables, and confirm if possible the hypothesis that awareness of illness relies on a broader tendency for self consciousness.In our population of 46 schizophrenic or schizoaffective inpatients, we failed to show any correlation between awareness of illness, anxiety or depression. Moreover, awareness of illness is not correlated with self-consciousness. On the other hand, anxiety and depression are correlated with self-consciousness. A tendency for high self reflection is frequently observed in autistic attitudes but also when the patient is in relation with others. Some patients sometimes feels like if a an “active” and a “reflexive” self were simultaneously present when they speak to others or even when they are doing daily life activities. The consequences are a loss of spontaneity, apragmatism, anxiety and depression. Those data are discussed in regard to phenomenological studies of Bin Kimura and to mescaline experiences described by the writer H. Michaux.