Victor Peralta1, Lucía Moreno-Izco2, Laura Calvo-Barrena2, Manuel J Cuesta2. 1. Psychiatry Unit-B, Complejo Hospitalario de Navarra, Pamplona, Spain. Electronic address: victor.peralta.martin@cfnavarra.es. 2. Psychiatry Unit-B, Complejo Hospitalario de Navarra, Pamplona, Spain.
Abstract
BACKGROUND: The phenotype of psychotic disorders is presumed to be heterogeneous, but the best way to describe this heterogeneity remains unclear. OBJECTIVE: To examine the lower-order and higher-order symptomatic architecture of psychotic disorders by means of factor analysis and the Schmid-Leiman transformation. METHODS: Patients experiencing their first episode of psychosis (n=486) were comprehensively examined for 70 symptomatic variables, which were subjected to principal components analysis followed by a Promax rotation. First-order factors were subjected to second-order factor analysis, and influence of second-order factors on primary factors was removed using the Schmid-Leiman transformation. RESULTS: First-order factor analysis revealed 13 primary factors that were substantially intercorrelated. Second-order factor analysis showed 5 higher-order factors with no substantial intercorrelations. The Schmid-Leiman transformation revealed that whereas the second-order factors accounted for most of the symptom covariance (63.5%), the first-order factors still accounted for an additional 36.5%. According to this transformation, five second-order factors (bipolar negative-mania, disorganization, psychomotor retardation, hallucinations and grandiosity) plus four first-order factors (depression, catatonia, bizarre delusions and paranoid delusions) best explained the factor structure of the symptoms. CONCLUSIONS: The phenotype of psychosis is more complex than previously acknowledged as it embraces a multidimensional hierarchical structure organized into nonredundant first- and second-order factors.
BACKGROUND: The phenotype of psychotic disorders is presumed to be heterogeneous, but the best way to describe this heterogeneity remains unclear. OBJECTIVE: To examine the lower-order and higher-order symptomatic architecture of psychotic disorders by means of factor analysis and the Schmid-Leiman transformation. METHODS:Patients experiencing their first episode of psychosis (n=486) were comprehensively examined for 70 symptomatic variables, which were subjected to principal components analysis followed by a Promax rotation. First-order factors were subjected to second-order factor analysis, and influence of second-order factors on primary factors was removed using the Schmid-Leiman transformation. RESULTS: First-order factor analysis revealed 13 primary factors that were substantially intercorrelated. Second-order factor analysis showed 5 higher-order factors with no substantial intercorrelations. The Schmid-Leiman transformation revealed that whereas the second-order factors accounted for most of the symptom covariance (63.5%), the first-order factors still accounted for an additional 36.5%. According to this transformation, five second-order factors (bipolar negative-mania, disorganization, psychomotor retardation, hallucinations and grandiosity) plus four first-order factors (depression, catatonia, bizarre delusions and paranoid delusions) best explained the factor structure of the symptoms. CONCLUSIONS: The phenotype of psychosis is more complex than previously acknowledged as it embraces a multidimensional hierarchical structure organized into nonredundant first- and second-order factors.
Authors: Roman Kotov; Katherine G Jonas; William T Carpenter; Michael N Dretsch; Nicholas R Eaton; Miriam K Forbes; Kelsie T Forbush; Kelsey Hobbs; Ulrich Reininghaus; Tim Slade; Susan C South; Matthew Sunderland; Monika A Waszczuk; Thomas A Widiger; Aidan G C Wright; David H Zald; Robert F Krueger; David Watson Journal: World Psychiatry Date: 2020-06 Impact factor: 49.548
Authors: Victor Peralta; Ximena Goldberg; María Ribeiro; Ana M Sanchez-Torres; Lourdes Fañanás; Manuel J Cuesta Journal: Schizophr Bull Date: 2015-12-26 Impact factor: 9.306