Background/Aims: Perception of space and objects is a traditional focus within phenomenology, and disturbances in these aspects of perception among people with schizophrenia have long been discussed within phenomenological psychiatry. Despite this, there has been little empirical work on the causes and effects of most of these perceptual alterations in people with schizophrenia. Progress towards this goal can be accelerated by the use of EAWE (Examination of Anomalous World Experience), an interview-based tool to elicit, categorize, and quantify abnormal perceptual and other experiential phenomena. Methods: In this brief paper, we review the main types of disturbances in space and object perception in schizophrenia - as described by phenomenologists, clinicians from other theoretical orientations, and experimental psychopathologists - as a first step in a research agenda to achieve a better integration of the clinical and experimental literatures. Results/Conclusion: This review indicates that in some cases the cognitive and neurobiological mechanisms of altered space and object perception in schizophrenia are relatively well understood, while in other cases there exist only plausible hypotheses. In still other cases, however, almost nothing is known. Moreover, a fundamental hypothesis of phenomenological psychiatry - that perceptual changes are related to disturbances in the sense of self - has yet to be investigated actively. From this context, we offer suggestions for future research and suggest general research designs that may be useful for advancing progress in this area.

1.
Sass L, Pienkos E, Skodlar B, et al: EAWE: Examination of anomalous world experience. Psychopathology 2017;50:10-54.
2.
Henriksen MG, Parnas J: Clinical manifestations of self-disorders and the gestalt of schizophrenia. Schizophr Bull 2012;38:657-660.
3.
Binswanger L: Das Raumproblem in der Psychopathologie; in Herzog M, Braun HJ, Fichtner G, Holzhey-Kunz A, Holzhey H, Jüttemann GH (eds): Ausgewählte Werke. Band 3: Vorträge und Aufsätze. Heidelberg, Asanger, 1994, pp 123-177.
4.
Conrad K: Die beginnende Schizophrenie. Versuch einer Gestaltanalyse des Wahns. Stuttgart, Thieme, 1958.
5.
Minkowski E: La Schizophrénie. Paris, Payot, 1927.
6.
Matussek P: Studies in delusional perception, transl, condensed; in Cutting J, Shepherd M (eds): Clinical Roots of the Schizophrenia Concept Translations of Seminal European Contributions on Schizophrenia. Cambridge, Cambridge University Press, 1987.
7.
Chapman J: The early symptoms of schizophrenia. Br J Psychiatry 1966;112:225-251.
8.
Sèchehaye M: Autobiography of a Schizophrenic Girl. New York, Signet Books, 1970.
9.
Silverstein SM, Keane BP: Perceptual organization impairment in schizophrenia and associated brain mechanisms: review of research from 2005 to 2010. Schizophr Bull 2011;37:690-699.
10.
Uhlhaas PJ, Silverstein SM: Perceptual organization in schizophrenia spectrum disorders: empirical research and theoretical implications. Psychol Bull 2005;131:618-632.
11.
Keane BP, Paterno D, Kastner S, Silverstein SM: Visual integration dysfunction in schizophrenia arises by the first psychotic episode and worsens with illness duration. J Abnorm Psychol 2016;125:543-549.
12.
Place EJ, Gilmore GC: Perceptual organization in schizophrenia. J Abnorm Psychol 1980;89:409-418.
13.
Silverstein SM, Knight RA, Schwarzkopf SB, West LL, Osborn LM, Kamin D: Stimulus configuration and context effects in perceptual organization in schizophrenia. J Abnorm Psychol 1996;105:410-420.
14.
Uhlhaas PJ, Phillips WA, Silverstein SM: The course and clinical correlates of dysfunctions in visual perceptual organization in schizophrenia during the remission of psychotic symptoms. Schizophr Res 2005;75:183-192.
15.
Silverstein SM, Elliott CM, Feusner JD, et al: Comparison of visual perceptual organization in schizophrenia and body dysmorphic disorder. Psychiatry Res 2015;229:426-433.
16.
Rabinowicz EF, Opler LA, Owen DR, Knight RA: Dot Enumeration Perceptual Organization Task (DEPOT): evidence for a short-term visual memory deficit in schizophrenia. J Abnorm Psychol 1996;105:336-348.
17.
Farmer AE, McGuffin P, Spitznagel EL: Heterogeneity in schizophrenia: a cluster-analytic approach. Psychiatry Res 1983;8:1-12.
18.
Butler PD, Abeles IY, Silverstein SM, et al: An event-related potential examination of contour integration deficits in schizophrenia. Front Psychol 2013;4:132.
19.
Uhlhaas PJ, Linden DE, Singer W, et al: Dysfunctional long-range coordination of neural activity during Gestalt perception in schizophrenia. J Neurosci 2006;26:8168-8175.
20.
Keri S, Kelemen O, Benedek G: Attentional modulation of perceptual organisation in schizophrenia. Cogn Neuropsychiatry 2009;14:77-86.
21.
Gross G, Huber G, Klosterkötter J, Linz M: BSABS: Bonn Scale for the Assessment of Basic Symptoms. Aachen, Shaker, 2008.
22.
Freedman BJ: The subjective experience of perceptual and cognitive disturbances in schizophrenia. A review of autobiographical accounts. Arch Gen Psychiatry 1974;30:333-340.
23.
Sass LA: Madness and Modernism: Insanity in the Light of Modern Art, Literature, and Thought. New York, BasicBooks, 1992.
24.
Craft E, Schutze H, Niebur E, von der Heydt R: A neural model of figure-ground organization. J Neurophysiol 2007;97:4310-4326.
25.
Lenzenweger MF: Schizotypy and schizophrenia: the view from experimental psychopathology. New York, Guilford Press, 2010.
26.
Cutting J: Principles of Psychopathology: Two Worlds, Two Minds, Two Hemispheres. New York, Oxford University Press, 1997.
27.
Boucart M, Humphreys GW, Lorenceau J: Automatic access to object identity: attention to global information, not to particular physical dimensions, is important. J Exp Psychol Hum Percept Perform 1995;21:584-601.
28.
Boucart M, Humphreys GW: Global shape cannot be attended without object identification. J Exp Psychol Hum Percept Perform 1992;18:785-806.
29.
Viertio S, Laitinen A, Perala J, et al: Visual impairment in persons with psychotic disorder. Soc Psychiatry Psychiatr Epidemiol 2007;42:902-908.
30.
Kantrowitz JT, Butler PD, Schecter I, Silipo G, Javitt DC: Seeing the world dimly: the impact of early visual deficits on visual experience in schizophrenia. Schizophr Bull 2009;35:1085-1094.
31.
Schechter I, Butler PD, Jalbrzikowski M, Pasternak R, Saperstein AM, Javitt DC: A new dimension of sensory dysfunction: stereopsis deficits in schizophrenia. Biol Psychiatry 2006;60:1282-1284.
32.
Stanghellini G: Schizophrenia and the sixth sense; in Chung MC, Fulford KWM, Graham G (eds): Reconceiving Schizophrenia. New York, Oxford University Press, 2007, pp 129-150.
33.
Klosterkötter J, Hellmich M, Steinmeyer EM, Schultze-Lutter F: Diagnosing schizophrenia in the initial prodromal phase. Arch Gen Psychiatry 2001;58:158-164.
34.
Silverstein SM, Keane BP, Wang Y, et al: Effects of short-term inpatient treatment on sensitivity to a size contrast illusion in first-episode psychosis and multiple-episode schizophrenia. Front Psychol 2013;4:466.
35.
Feigenson K, Hanson C, Papathomas TV, Silverstein SM: A functional MRI index of spatial context effects in vision. Psychology 2015;6:2145-2154.
36.
Bragman LJ: The case of Dante Gabriel Rossetti: a psychological study of a chloral addict. Am J Psychiatry 1936;92:1111-1122.
37.
Caputo GB, Ferrucci R, Bortolomasi M, Giacopuzzi M, Priori A, Zago S: Visual perception during mirror gazing at one's own face in schizophrenia. Schizophr Res 2012;140:46-50.
38.
Fonseca-Pedrero E, Badoud D, Antico L, et al: Strange-face-in-the-mirror illusion and schizotypy during adolescence. Schizophr Bull 2015;41(suppl 2):S475-S482.
39.
McGhie A, Chapman J: Disorders of attention and perception in early schizophrenia. Br J Med Psychol 1961;34:103-115.
40.
Silverstein SM, Rosen R: Schizophrenia and the eye. Schizophr Res Cogn 2015;2:46-55.
41.
Witkovsky P: Dopamine and retinal function. Doc Ophthalmol 2004;108:17-40.
42.
Cegalis JA, Leen D, Solomon EJ: Attention in schizophrenia: an analysis of selectivity in the functional visual field. J Abnorm Psychol 1977;86:470-482.
43.
Straus E: Aesthesiology and hallucination; in May R, Angel E, Ellenberger HF (eds): Existence. Northvale, Aronson, 1994, pp 139-169.
44.
Pinkham AE, Sasson NJ, Beaton D, Abdi H, Kohler CG, Penn DL: Qualitatively distinct factors contribute to elevated rates of paranoia in autism and schizophrenia. J Abnorm Psychol 2012;121:767-777.
45.
Schiffman J, Maeda JA, Hayashi K, et al: Premorbid childhood ocular alignment abnormalities and adult schizophrenia-spectrum disorder. Schizophr Res 2006;81:253-260.
46.
Schubert EW, Henriksson KM, McNeil TF: A prospective study of offspring of women with psychosis: visual dysfunction in early childhood predicts schizophrenia-spectrum disorders in adulthood. Acta Psychiatr Scand 2005;112:385-393.
47.
Waters F, Collerton D, Ffytche DH, et al: Visual hallucinations in the psychosis spectrum and comparative information from neurodegenerative disorders and eye disease. Schizophr Bull 2014;40(suppl 4):S233-S245.
48.
Teeple RC, Caplan JP, Stern TA: Visual hallucinations: differential diagnosis and treatment. Prim Care Companion J Clin Psychiatry 2009;11:26-32.
49.
Phillipson OT, Harris JP: Perceptual changes in schizophrenia: a questionnaire survey. Psychol Med 1985;15:859-866.
50.
Marneros A, Korner J: Chronic palinopsia in schizophrenia. Psychopathology 1993;26:236- 239.
51.
Wagner P, Spiro CS: Divided Minds: Twin Sisters and Their Journey through Schizophrenia. New York, St. Martin's Press, 2008.
52.
Cutting J: The Right Cerebral Hemisphere and Psychiatric Disorders. New York, Oxford University Press, 1990.
53.
Karnath HO: Spatial orientation and the representation of space with parietal lobe lesions. Philos Trans R Soc Lond B Biol Sci 1997;352:1411-1419.
54.
Austin J: Zen and the Brain. Cambridge, MIT Press, 1998.
55.
Yildiz M, Borgwardt SJ, Berger GE: Parietal lobes in schizophrenia: do they matter? Schizophr Res Treatment 2011;2011:581686.
56.
Lee A, Harris J: Problems with perception of space in Parkinson's disease: a questionnaire study. Neuro-Opthalmology 1999;22:1-15.
57.
Richard A, Churan J, Whitford V, O'Driscoll GA, Titone D, Pack CC: Perisaccadic perception of visual space in people with schizophrenia. J Neurosci 2014;34:4760-4765.
58.
Thakkar KN, Schall JD, Heckers S, Park S: Disrupted saccadic corollary discharge in schizophrenia. J Neurosci 2015;35:9935-9945.
59.
Yoshitsugu K, Yamada K, Toyota T, et al: A novel scale including strabismus and “cuspidal ear” for distinguishing schizophrenia patients from controls using minor physical anomalies. Psychiatry Res 2006;145:249-258.
60.
Cumurcu T, Cumurcu BE, Ozcan O, et al: Social phobia and other psychiatric problems in children with strabismus. Can J Ophthalmol 2011;46:267-270.
61.
Pratt-Johnson JA: Emotional factors in strabismus. Can J Ophthalmol 1977;12:258-260.
62.
Rodriguez E, George N, Lachaux JP, Martinerie J, Renault B, Varela FJ: Perception's shadow: long-distance synchronization of human brain activity. Nature 1999;397:430-433.
63.
Lutz A, Lachaux JP, Martinerie J, Varela FJ: Guiding the study of brain dynamics by using first-person data: synchrony patterns correlate with ongoing conscious states during a simple visual task. Proc Natl Acad Sci USA 2002;99:1586-1591.
64.
Silbersweig DA, Stern E, Frith C, et al: A functional neuroanatomy of hallucinations in schizophrenia. Nature 1995;378:176-179.
65.
Thompson E, Varela FJ: Radical embodiment: neural dynamics and consciousness. Trends Cogn Sci 2001;5:418-425.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.