Page 62 - JCBP-2-1

Journal of Clinical and
Basic Psychosomatics Exteroceptive/interoceptive processing

controls (HCs). We expected to observe stable differences 2.3. Study protocol
(or similarities) in perceptual profiles when comparing For PSY patients, the first evaluation was conducted within
PSY-T1 with HC and, likewise, when comparing PSY-T2 48 h of admission to the Acute Psychiatric Inpatient Unit
with HC.
(T0, acute phase), during which the Positive and Negative
[25]
2. Methods Syndrome Scale (PANSS) was administered and scored
by a trained medical doctor. Perceptual profiles (MAIA
2.1. Study design and AASP) were not collected at this time point due to
We performed a monocentric observational longitudinal the potentially excessive distress their administration
study that adhered to the STrengthening the Reporting could have caused to participants. The second evaluation
of OBservational studies in Epidemiology (STROBE) (T1, post-acute phase) took place at discharge. Patients
guidelines . In compliance with the Declaration of were re-evaluated using PANSS, and the MAIA and
[24]
Helsinki, our research received approval from the local AASP questionnaires were administered to assess
[20]
ethical committee of the IRCCS Policlinico San Matteo interoceptive and exteroceptive profiles, respectively.
(Pavia, Italy) under protocol number 20210003663. Each Demographic variables, including age, gender, DSM-5
participant was informed of the study’s purposes and diagnosis, illness duration, mean antipsychotic dosage
provided written informed consent in accordance with (olanzapine equivalents) , mean antidepressant dose
[26]
their legal civilian capabilities. (fluoxetine equivalents) , and mean benzodiazepine dose
[27]
(diazepam equivalents) , were collected at this time point.
[28]
2.2. Participants The final assessment (T2) was performed 6 – 12 weeks
We recruited 23 PSY patients who were admitted to the after discharge and involved the same tests administered at
Acute Psychiatric Inpatient Unit of ASST Pavia at IRCCS T1. The timing of assessment at T2 varied, as participants
Policlinico San Matteo in Pavia, Italy, between May 1 , needed to be free from active symptoms that would
st
2021 and May 1 , 2022. The sampling procedure used require hospitalization. In the present study, remission was
st
was convenience based; the study was proposed to all the defined not solely as the absence of symptom s but rather
patients hospitalized during the indicated period who met as the absence of an acute psychotic phase. HCs were
the inclusion and exclusion criteria. Those who agreed to administered only the AASP and MAIA questionnaires at
participate were enrolled in the study. Inclusion criteria a single time point.
encompassed age between 18 and 65, a DSM-5 diagnosis
of psychotic disorder (including schizophrenia, other 2.4. Measurements of outcomes
psychotic disorders, psychosis due to substance use, and The MAIA is an instrument designed to evaluate
psychosis not otherwise specified), or unipolar/bipolar subjective sensitivity toward inner body sensations. It
mood disorder with psychotic symptoms, fluency in consists of 32 items scored according to the frequency
Italian, and the ability to sign a written informed consent. of each behavior, with “0” indicating “never” and “5”
Exclusion criteria included comorbid neurological indicating “always.” These items are grouped into eight
disorders that may be the primary cause of psychotic subscales: “Noticing,” “Not distracting,” “Not worrying,”
symptoms, intellectual disability, and any permanent “Attention regulation,” “Emotional awareness,” “Self-
condition potentially impairing sensory processing regulation,” “Body listening,” and “Trusting.” In addition to
(i.e., blindness, deafness, major motor concerns, dysgeusia, its application in psychosis [29,30] , the MAIA questionnaire
and anosmia). Evaluations were carried out by trained has been used in various psychiatric conditions, such as
medical doctors, and all diagnoses were confirmed by autism, eating disorders, depression, and other disorders
two psychiatrists according to DSM-5 criteria. We also involving interoception, such as chronic pain syndrome,
collected data from 210 HC selected from the general fibromyalgia, and low back pain [20,22,31-36] .
population. Inclusion criteria for HC were age between 18
and 65, fluency in Italian, and the ability to sign a written The AASP is an evaluation scale designed to measure
informed consent. Exclusion criteria encompassed being individual responses to sensory experiences encountered
diagnosed with a psychiatric disorder and/or intellectual in everyday life. Participants were asked to indicate the
disability, use of psychoactive substances within 1 month frequency with which they adopt specific behaviors, ranging
before test submission, and any permanent condition from rarely (5% or less of the time) to very frequently (95%
potentially impairing sensory processing (i.e., blindness, or more of the time). The AASP scale consists of 60 items
deafness, major motor concerns, dysgeusia, and anosmia). subdivided into four major categories that evaluate specific
Furthermore, patients subject to a legal guardianship responses to sensory stimuli. The “Sensory sensitivity” and
measure were preventively excluded from the study. “Low regulation” subscales evaluate the passive sensory

Volume 2 Issue 1 (2024) 3 https://doi.org/10.36922/jcbp.1764