A symptom-based continuum of psychosis explains cognitive and real-world functional deficits better than traditional diagnoses.
Schizophr Res
; 208: 344-352, 2019 06.
Article
in En
| MEDLINE
| ID: mdl-30711315
ABSTRACT
BACKGROUND:
Patients with psychotic spectrum disorders share overlapping clinical/biological features, making it often difficult to separate them into a discrete nosology (i.e., Diagnostic and Statistical Manual of Mental Disorders [DSM]).METHODS:
The current study investigated whether a continuum classification scheme based on symptom burden would improve conceptualizations for cognitive and real-world dysfunction relative to traditional DSM nosology. Two independent samples (New Mexico [NM] and Bipolar and Schizophrenia Network on Intermediate Phenotypes [B-SNIP]) of patients with schizophrenia (NM Nâ¯=â¯93; B-SNIP Nâ¯=â¯236), bipolar disorder Type I (NM Nâ¯=â¯42; B-SNIP Nâ¯=â¯195) or schizoaffective disorder (NM Nâ¯=â¯15; B-SNIP Nâ¯=â¯148) and matched healthy controls (NM Nâ¯=â¯64; B-SNIP Nâ¯=â¯717) were examined. Linear regressions examined how variance differed as a function of classification scheme (DSM diagnosis, negative and positive symptom burden, or a three-cluster solution based on symptom burden).RESULTS:
Symptom-based classification schemes (continuous and clustered) accounted for a significantly larger portion of captured variance of real-world functioning relative to DSM diagnoses across both samples. The symptom-based classification schemes accounted for large percentages of variance for general cognitive ability and cognitive domains in the NM sample. However, in the B-SNIP sample, symptom-based classification schemes accounted for roughly equivalent variance as DSM diagnoses. A potential mediating variable across samples was the strength of the relationship between negative symptoms and impaired cognition.CONCLUSIONS:
Current results support suggestions that a continuum perspective of psychopathology may be more powerful for explaining real-world functioning than the DSM diagnostic nosology, whereas results for cognitive dysfunction were sample dependent.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Psychotic Disorders
/
Cognition Disorders
/
Emotional Intelligence
/
Symptom Assessment
Type of study:
Diagnostic_studies
/
Guideline
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Schizophr Res
Journal subject:
PSIQUIATRIA
Year:
2019
Document type:
Article