Hierarchical Symptom Components in Early Psychosis.
Schizophr Bull
; 48(4): 893-901, 2022 06 21.
Article
in En
| MEDLINE
| ID: mdl-35639737
ABSTRACT
BACKGROUND AND HYPOTHESIS:
Quantitative models of psychopathology can empirically guide subclassification of heterogeneous clinical presentations such as psychosis; they are particularly well-equipped to capture the nuanced symptomatology observed in first-episode psychosis. As well, components may be better aligned with biological variables. The current study sought to confirm and extend knowledge of the hierarchical structure of psychosis symptoms in first-episode psychosis. Based on past hierarchical work, we hypothesized that a 4 component level would be most closely associated with longitudinal disability. STUDYDESIGN:
Participants with early-stage psychosis (Nâ =â 370) underwent clinical assessment with the scale for the assessment of positive symptoms (SAPS), scale for assessment of negative symptoms (SANS), and global assessment scale(GAS). A subset was assessed at 6 months (Nâ =â 221) and 1 year (Nâ =â 207). Hierarchical symptom components were extracted at 12 levels. The predictive utility of the components for global functioning was tested. STUDYRESULTS:
As predicted, the 4-component model (reality distortion, thought disorder, inexpressivity, apathy/asociality) provided a superior prediction of functioning over other levels of the hierarchy. Baseline apathy/asociality longitudinally predicted functioning beyond the shared variance of the components at 6 months (bâ =â -4.83, t(216)â =â -5.37, pâ <â .001, R2adjâ =â 0.12) and 1-year (bâ =â -4.49, t(202)â =â -4.38, pâ <â .001, R2adjâ =â 0.09).CONCLUSIONS:
The hierarchical structure of psychotic symptomatology and its external validity have been robustly established in independent, longitudinal first-episode psychosis samples. The established model incorporates multiple levels of granularity that can be flexibly applied based on the level that offers the greatest predictive utility for external validators.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Psychotic Disorders
/
Apathy
Type of study:
Diagnostic_studies
/
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
Schizophr Bull
Year:
2022
Document type:
Article