Schizophrenia commonly involves experiencing unusual bodily sensations like alterations in body size, foreign body sensations, or depersonalization.

Abnormal bodily sensations, referred to as cenesthesia, are frequently observed in schizophrenia.

Individuals experiencing cenesthesia may describe sensations like perceiving their limbs as larger or longer than normal or sensing a foreign object within their body.

Even though these sensations are common, they often slip under the radar or are misinterpreted, making it challenging to accurately diagnose cenesthopathic schizophrenia (an informal subtype of schizophrenia primarily characterized by these distinct experiences).

Cenesthopathic schizophrenia is a term used in psychiatry to describe a subtype or manifestation of schizophrenia characterized by prominent and distressing bodily sensations or abnormal bodily experiences, which are known as cenesthesias.

These experiences involve unusual bodily feelings or perceptions that might include sensations of internal discomfort, altered bodily awareness, or abnormalities in bodily functions. These symptoms might not fit neatly into the typical positive or negative symptom categories of schizophrenia.

Diagnostic criteria for cenesthopathic schizophrenia

Cenesthopathic schizophrenia isn’t defined explicitly as a distinct diagnostic category in standard psychiatric classifications such as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).

Diagnosis relies on identifying cenesthesia within the context of an existing diagnosis of schizophrenia or a related psychotic disorder.

Psychiatrists diagnose the condition with a thorough evaluation of symptoms, clinical history, and observation of various psychotic and cognitive symptoms, including any unusual bodily experiences reported by the individual.

Symptoms of cenesthopathic schizophrenia may include:

  • Abnormal bodily sensations: This involves unusual bodily sensations that are often described as strange or disturbing. These may include tingling, a feeling of pressure or heaviness, sensations of movement or internal shifting within your body, or the feeling of foreign objects in your body without any actual physical evidence.
  • Heightened awareness or preoccupation with bodily sensations: You may be overly focused on or disturbed by regular bodily sensations, such as heartbeat or breathing.
  • Distorted body image: Some individuals may experience altered perceptions of their body size, shape, or structure, leading to a distorted body image perception.
  • Depersonalization: This refers to a sense of disconnection from yourself or feeling detached from your thoughts, feelings, or body.
  • Motor weakness: This involves a perceived loss of strength or control over your movements, without any apparent physical basis.

Current research on cenesthopathic schizophrenia is limited. A 2009 study of 70 individuals who received a diagnosis of paranoid schizophrenia (a subtype of schizophrenia no longer recognized in the DSM) found that symptoms related to cenesthesias, like depersonalization, motor weakness, and abnormal sensations, were quite common.

Participants often underestimated the size of their lower extremities (legs, ankles, and feet), and these perceptions were linked with symptom severity. Notably, these sensations were present in a substantial portion of participants even before psychosis symptoms appeared.

A 2012 study looked at unique bodily experiences among people experiencing their first episode of schizophrenia. Among the participants, 30 out of 39 reported unusual bodily sensations.

The authors note that recognizing these specific bodily experiences in early stage schizophrenia may help distinguish it from other conditions that also affect bodily perception.

Plus, understanding how these experiences evolve into more elaborate bodily delusions could improve our understanding of highly unusual beliefs in schizophrenia.

  • Altered limb sensations: This may involve feeling like your limbs are changing in size, such as becoming larger or smaller than usual. It could also involve sensations of your limbs elongating, shrinking, or changing in shape without any physical changes.
  • Internal movements: This may involve perceiving internal movements within your body that seem unexplainable or abnormal, such as sensations of organs moving or functioning differently than they typically do.
  • The feeling of foreign bodies: Some individuals experience the sensation of having foreign objects inside their body, such as feeling like there are wires, coils, or objects lodged internally.
  • Feeling controlled: Individuals might describe a sensation of their bodily actions or functions being controlled or manipulated by external forces, leading them to believe that their movements or bodily sensations aren’t self-initiated.
  • Depersonalization: This may manifest as a sense of detachment from one’s own thoughts, emotions, or body. Individuals might describe feeling like an observer of their own actions, experiencing an unreal or dreamlike state, or perceiving their thoughts and sensations as distant or disconnected.

Cenesthopathic schizophrenia’s exact cause is unclear. It’s believed to result from a complex interplay of genetic, environmental, and neurobiological factors, much like other forms of schizophrenia.

These abnormal bodily sensations may stem from disturbances in brain function, possibly involving areas associated with perception, interpretation, and processing of sensory information.

In a study of 30 participants with psychiatric disorders who were recruited from a psychiatry unit, the researchers found that a large majority (83.3%) displayed cenesthopathy, which correlated with specific symptoms related to fear, compulsions, and cognitive thought issues.

Cognitive thought difficulties emerged as a significant predictor, suggesting a link between cenesthopathy and cognitive abnormalities like impaired thinking processes and speech perception in these individuals.

There’s no specific medication exclusively for cenesthopathic schizophrenia. Treatment often involves a combination of approaches:

  • Medication: Antipsychotic medications may be prescribed to alleviate symptoms of psychosis. But, their efficacy in treating cenesthopathic symptoms specifically might be limited.
  • Psychotherapy: Therapies like cognitive behavioral therapy (CBT) can help individuals manage their symptoms, cope with distress, and address cognitive distortions.
  • Supportive care: Supportive environments, rehabilitation programs, and social support networks can assist in managing daily life and addressing challenges associated with the condition.
  • Complementary approaches: Some individuals find complementary techniques, like mindfulness, helpful in managing distress or anxiety associated with these symptoms.

Cenesthopathy is a complex condition marked by unusual bodily sensations and often intersects with schizophrenia. But, diagnosing cenesthopathy or cenesthopathic schizophrenia is uncommon in clinical settings.

In standardized psychiatric classifications such as the DSM-5-TR, there isn’t a universally accepted or precisely defined category for cenesthopathic schizophrenia.

If you or someone you know is experiencing symptoms of cenesthopathy or schizophrenia, seeking guidance from a mental health professional is crucial for getting started on an appropriate treatment plan.