TY - JOUR
T1 - Transdiagnostic dimensions of psychopathology at first episode psychosis
T2 - findings from the multinational EU-GEI study
AU - Quattrone, Diego
AU - Di Forti, Marta
AU - Gayer-Anderson, Charlotte
AU - Ferraro, Laura
AU - Jongsma, Hannah E.
AU - Tripoli, Giada
AU - La Cascia, Caterina
AU - La Barbera, Daniele
AU - Tarricone, Ilaria
AU - Berardi, Domenico
AU - Szoke, Andrei
AU - Arango, Celso
AU - Lasalvia, Antonio
AU - Tortelli, Andrea
AU - Llorca, Pierre-Michel
AU - de Haan, Lieuwe
AU - Velthorst, Eva
AU - Bobes, Julio
AU - Bernardo, Miguel
AU - Sanjuan, Julio
AU - Luis Santos, Jose
AU - Arrojo, Manuel
AU - Del-Ben, Cristina Marta
AU - Menezes, Paulo Rossi
AU - Selten, Jean-Paul
AU - Jones, Peter B.
AU - Kirkbride, James B.
AU - Richards, Alexander L.
AU - O'Donovan, Michael C.
AU - Sham, Pak C.
AU - Vassos, Evangelos
AU - Rutten, Bart P. F.
AU - van Os, Jim
AU - Morgan, Craig
AU - Lewis, Cathryn M.
AU - Murray, Robin M.
AU - Reininghaus, Ulrich
AU - Hubbard, Kathryn
AU - Beards, Stephanie
AU - Stilo, Simona A.
AU - Parellada, Mara
AU - Cuadrado, Pedro
AU - Rodriguez Solano, Jose Juan
AU - Carracedo, Angel
AU - Garcia Bernardo, Enrique
AU - Roldan, Laura
AU - Lopez, Gonzalo
AU - Cabrera, Bibiana
AU - Lorente-Rovira, Esther
AU - Garcia-Portilla, Paz
AU - EU-GEI WP2 Group
N1 - Publisher Copyright:
© Cambridge University Press 2018.
PY - 2019/6
Y1 - 2019/6
N2 - Background. The value of the nosological distinction between non-affective and affective psychosis has frequently been challenged. We aimed to investigate the transdiagnostic dimensional structure and associated characteristics of psychopathology at First Episode Psychosis (FEP). Regardless of diagnostic categories, we expected that positive symptoms occurred more frequently in ethnic minority groups and in more densely populated environments, and that negative symptoms were associated with indices of neurodevelopmental impairment.Method. This study included 2182 FEP individuals recruited across six countries, as part of the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study. Symptom ratings were analysed using multidimensional item response modelling in Mplus to estimate five theory-based models of psychosis. We used multiple regression models to examine demographic and context factors associated with symptom dimensions.Results. A bifactor model, composed of one general factor and five specific dimensions of positive, negative, disorganization, manic and depressive symptoms, best-represented associations among ratings of psychotic symptoms. Positive symptoms were more common in ethnic minority groups. Urbanicity was associated with a higher score on the general factor. Men presented with more negative and less depressive symptoms than women. Early age-at-first-contact with psychiatric services was associated with higher scores on negative, disorganized, and manic symptom dimensions.Conclusions. Our results suggest that the bifactor model of psychopathology holds across diagnostic categories of non-affective and affective psychosis at FEP, and demographic and context determinants map onto general and specific symptom dimensions. These findings have implications for tailoring symptom-specific treatments and inform research into the mood-psychosis spectrum.
AB - Background. The value of the nosological distinction between non-affective and affective psychosis has frequently been challenged. We aimed to investigate the transdiagnostic dimensional structure and associated characteristics of psychopathology at First Episode Psychosis (FEP). Regardless of diagnostic categories, we expected that positive symptoms occurred more frequently in ethnic minority groups and in more densely populated environments, and that negative symptoms were associated with indices of neurodevelopmental impairment.Method. This study included 2182 FEP individuals recruited across six countries, as part of the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study. Symptom ratings were analysed using multidimensional item response modelling in Mplus to estimate five theory-based models of psychosis. We used multiple regression models to examine demographic and context factors associated with symptom dimensions.Results. A bifactor model, composed of one general factor and five specific dimensions of positive, negative, disorganization, manic and depressive symptoms, best-represented associations among ratings of psychotic symptoms. Positive symptoms were more common in ethnic minority groups. Urbanicity was associated with a higher score on the general factor. Men presented with more negative and less depressive symptoms than women. Early age-at-first-contact with psychiatric services was associated with higher scores on negative, disorganized, and manic symptom dimensions.Conclusions. Our results suggest that the bifactor model of psychopathology holds across diagnostic categories of non-affective and affective psychosis at FEP, and demographic and context determinants map onto general and specific symptom dimensions. These findings have implications for tailoring symptom-specific treatments and inform research into the mood-psychosis spectrum.
KW - Bifactor model
KW - diagnostic categories
KW - first episode psychosis
KW - psychopathology
KW - symptom dimensions
KW - NEGATIVE SYNDROME SCALE
KW - BIPOLAR DISORDER
KW - SYMPTOM DIMENSIONS
KW - BIFACTOR MODEL
KW - GENETIC-RELATIONSHIPS
KW - GENDER-DIFFERENCES
KW - SEX-DIFFERENCES
KW - 5-FACTOR MODEL
KW - WORKING GROUP
KW - DSM-V
U2 - 10.1017/S0033291718002131
DO - 10.1017/S0033291718002131
M3 - Article
C2 - 30282569
SN - 0033-2917
VL - 49
SP - 1378
EP - 1391
JO - Psychological Medicine
JF - Psychological Medicine
IS - 8
ER -