REVIEWS   

Minerva Psichiatrica 2004 March;45(1):19-28

Copyright © 2004 EDIZIONI MINERVA MEDICA

language: Italian

Schizophrenia, autism, idionomia, dis-sociality

Ballerini M.

Schizophrenic autism is more effective than psychotic symptoms in describing the core feature of schizophrenia. It is a specific trait-like character involving the whole person and his social relationships; it is a phenomenic/phenotypic marker of schizophrenic vulnerability and a meaning structure, present in the prodromic period and in the following course becoming a more and more evident structure. Schizophre-nic vulnerability, an on-going and dynamic condition, runs differently in different persons featuring temperamental traits stable configuration of personality and clinical schizophrenia. Autism is here considered on 3 levels of analysis: the 1st, the semeiological level (social withdrawal, lack of empathy and odd thinking); the 2nd, the psychopathological level (the private world constitution); the 3rd, the phenomenological level (a primary disturbance of intersubjectivity, the social feature of one own's experience). The phenomenological perspective describes autism on the social and egological sides of experience, showing on one hand dis-sociality (the detachment from common sense evidences, the cornerstone of social life), on the other idionomia (constitution of an elusive, enigmatic, odd and stubborn personal frame). Of autism is psychopathological roots we find a disturbance of self-constitution (ipseity disorder) evolving into ontological insecurity (the threatening character of social life), hyper-reflexivity and solipsism (hyper-subjectivation of experience and subtle grandiosity), antagonomia ‹ hyper-tolerance of ambiguity (rejection of shared values and basic ambivalence). All these phenomena reflect a coping mechanism toward the disturbance of self - constitution but patient conative attempt to mantain contact with the social world through an idionomic perspective.