Most influential symptoms in the early detection of clinical high risk for psychosis in Indonesia: A basic symptom network

Basic symptoms (BS) are subtle, self-experienced disturbances in mental processes. Cognitive, visual and acoustic BS were included in clinical-high risk criteria for psychosis (CHR-P). So far, their interplay has been studied only in Western samples and always in concert with other symptoms, such as (attenuated) psychotic symptoms. Thus, we studies the interrelation of the 56 BS assessed with the ‘Schizophrenia Proneness Instrument, Adult version’, in an Indonesian sample of CHR-P patients (N = 108) 16–30 years-of-age, 18.95 % male) according to BS criteria using network analysis. The used estimator partially correlates with the Gaussian graphical model (GGM) and graph module. Model selection uses regularization techniques by setting λ = 0.05. The most central and traversed nodes in the robust, stable network were visual disturbances—‘near- and tele-vision’, ‘disturbances of the perception of straight lines/contours’ and ‘micropsia, macropsia’. Visual disturbances were also predominately involved in the 16 strongest edges, thereby linking strongly with alienation experiences. Contrary to networks in Western samples in that cognitive BS played a central and important role, subjective visual disturbances seem to play an important role in the possible emergence and maintenance of BS, in particular of alienation experiences, in Indonesian patients with CHR-P. Future studies should therefore study this potential role longitudinally along with their neurobio/cognitive underpinnings. Furthermore, it should be studies, if cognitive-behavioral therapy as suggested for alienation experiences may prevent progression and reduce symptom load.