Abnormal Body Phenomena in Persons with Major Depressive Disorder, 2021, Stanghellini et al

Abstract

Background: Depressive disorders, despite being classified as mood or affective disorders, are known to include disturbances in the experience of body, space, time, and intersubjectivity. However, current diagnostic manuals largely ignore these aspects of depressive experience. In this article, we use phenomenological accounts of embodiment as a theoretical foundation for a qualitative study of abnormal body phenomena (ABP) in depressive disorders.

Methods: 550 patients affected by schizophrenic and affective disorders were interviewed in a clinical setting. Interviews sought to uncover the qualitative features of experiences through self-descriptions. Clinical files were subsequently digitized and re-examined using consensual qualitative research.

Results: Ninety-nine out of 100 patients with MDD reported at least one ABP. From cross-analysis of the MDD sample, we obtained 4 general categories of ABP, 3 of which had additional subcategories. The 4 categories include slowed embodied temporality (N = 90), anomalous vital rhythms (N = 82), worries about one’s body (N = 22), and body deformation (N = 47).

Conclusions: The results provide empirical evidence in support of theoretical discussions of embodiment in MDD found in the work of classical and contemporary phenomenologists. The findings also provide nuanced insight into the experience of persons living with MDD. Some categories of ABP, like slowed embodied temporality, can help to finely characterize psychomotor retardation or the so-called “medically unexplained symptoms” (MUS). This fine-tuned characterization can help to connect MUS to neuropsychological and neurobiological (e.g., alterations of interoceptive processes linked to anomalies of the brain resting-state hypothesis) and inflammatory (e.g., studies linking environmental stressors, inflammation mediators, and neurovegetative and affective symptoms) models of MDD.

Our results can also support a pathogenic model of MDD, which posits, on the phenomenal level, ABP as the point of departure for the development of secondary symptoms including cognitive elaborations of these, namely, delusions about the body. Moreover, some of the categories, when contrasted with phenomenological qualitative studies of other disorders, provide conceptual resources of differential diagnosis and of identifying a “depressive core syndrome.” For example, findings within category 4, deformation of the body, provide resources for using ABP to distinguish between MDD and schizophrenia.

Paywall, https://www.karger.com/Article/Abstract/514642

 

It is somewhat interesting to explore MDD people's experience of the body. Or it would be if there wasn't so much nonsense in the piece. Not to mention waffly jargon.

What the %$#@? Yes there are some reports suggesting anomalies in the resting state patterns of brain activity in MDD. But we absolutely can NOT say they reflect "alteration in interoceptive processes", they could just as well effect the fact that people with MDD find it enormously challenging to travel to a hospital, let alone undergo a scan, and are actively compensating in some way.

And these body-related experiences are not in any way similar to the kinds of symptoms often labelled MUS, what an extraordinary leap!

Apparently, these body-related experiences demonstrate that MDD is embodied (what an extraordinary tautology). But at the same time they are described "cognitive elaborations". As if people with MDD were actually generating them by thinking on them too much. Here's an idea: maybe people don't think themselves into MDD at all? Maybe the negative thoughts are a product of the mood disorder, not its root cause? It would seem so blindingly obvious, but we have a whole industry founded on the "cognitive" view of depression.