Application of EAWE interview in a young patient with first psychotic episode

Psychopathology is a key domain of psychiatry, crucial for diagnosis, building relational depth with the patient, and ensuring adherence to treatment plans. The Examination of Anomalous World Experiences (EAWE) interview aims to help clinicians explore their patients’ subjective world experiences. We describe the lived world of a young male with a first psychotic episode, eliciting his first-person perspective of time, space, relationships with others, and worldviews. The 20-year-old patient presented with persecutory, paranoid, and hypochondriacal delusions, auditory pseudo-hallucinations, visual hallucinations, changes in perceived atmosphere and vitality, affect flattening, and social withdrawal. Experiences such as internal time feeling slower than external time, and a sense of remoteness from others—found to be common in patients with a first psychotic episode—were also present in our patient’s case. Anomalous world experiences, together with anomalous self-experiences, may eventually be useful for diagnosis and prognosis by identifying specific profiles in certain patient clusters, and by helping construct models of pathogenetic pathways to psychosis in general.