Matteo Tonna1, Paolo Ossola1, Carlo Marchesi1, Elena Bettini1, Antonio Lasalvia2, Chiara Bonetto3, Jacopo Lenzi4, Paola Rucci4, Laura Iozzino3, Massimo Cellini5, Carla Comacchio3, Doriana Cristofalo3, Armando D'Agostino6, Giovanni de Girolamo7, Katia De Santi2, Daniela Ghigi8, Emanuela Leuci9, Maurizio Miceli5, Anna Meneghelli10, Francesca Pileggi11, Silvio Scarone6, Paolo Santonastaso12, Stefano Torresani13, Sarah Tosato3, Angela Veronese12, Angelo Fioritti11, Mirella Ruggeri2,3. 1. Dipartimento di Medicina e Chirurgia, Unità di Psichiatria, Università di Parma, Parma, Italy. 2. UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) Verona, Verona, Italy. 3. Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy. 4. Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy. 5. Department of Mental Health, Az. USL Firenze, Florence, Italy. 6. Department of Psychiatry, University of Milano, Milan, Italy. 7. Psychiatric Epidemiology and Evaluation Unit, IRCSS St John of God Clinical Research Centre of Brescia, Brescia, Italy. 8. Department of Mental Health, Az. USL Rimini, Rimini, Italy. 9. Department of Mental Health, Az. USL Parma, Parma, Italy. 10. AO Ospedale Niguarda Ca' Granda Milano, MHD Programma2000, Milan, Italy. 11. Department of Mental Health, Az.USL Bologna, Bologna, Italy. 12. Department of Neurosciences, University of Padova and Azienda Ospedaliera, Padova, Italy. 13. Department of Mental Health, Az. USL Bolzano, Bolzano, Italy.
Abstract
AIM: Current diagnostic systems, DSM-5 and ICD-10, still adopt a categorical approach to classify psychotic disorders. The present study was aimed at investigating the structure of psychotic symptomatology in both affective and non-affective psychosis from a dimensional approach. METHODS:Participants with a first episode psychosis (FEP) were recruited from a cluster-randomized controlled trial (GET-UP PIANO TRIAL), offered to all Community Mental Health Centres (CMHCs) located across two northern Italian regions. After clinical stabilization, patients were assessed with a comprehensive set of psychopathological measures including the Positive and Negative Syndrome Scale, the Hamilton Depression Rating Scale and the Bech-Rafaelsen Mania Rating Scale. A two-step cluster analysis was performed. RESULTS: Overall, 257 FEP patients (male, n = 171, 66.5%; mean age = 24.96 ± 4.56) were included in the study. The cluster analysis revealed a robust four-cluster solution: delusional-persecutory (n = 82; 31.9%), depressed (n = 95; 37%), excited (n = 26; 10.1%) and negative-disorganized (n = 54; 21%), thus suggesting a quadripartite structure with both affective and non-affective dimensions. Among non-affective dimensions, negative and disorganization symptoms constituted a unique construct apart from positive symptoms. CONCLUSIONS: Symptom dimensions may represent a useful tool for dissecting the indistinct and non-specific psychopathology of FEP in order to better target specific interventions.
RCT Entities:
AIM: Current diagnostic systems, DSM-5 and ICD-10, still adopt a categorical approach to classify psychotic disorders. The present study was aimed at investigating the structure of psychotic symptomatology in both affective and non-affective psychosis from a dimensional approach. METHODS:Participants with a first episode psychosis (FEP) were recruited from a cluster-randomized controlled trial (GET-UP PIANO TRIAL), offered to all Community Mental Health Centres (CMHCs) located across two northern Italian regions. After clinical stabilization, patients were assessed with a comprehensive set of psychopathological measures including the Positive and Negative Syndrome Scale, the Hamilton Depression Rating Scale and the Bech-Rafaelsen Mania Rating Scale. A two-step cluster analysis was performed. RESULTS: Overall, 257 FEP patients (male, n = 171, 66.5%; mean age = 24.96 ± 4.56) were included in the study. The cluster analysis revealed a robust four-cluster solution: delusional-persecutory (n = 82; 31.9%), depressed (n = 95; 37%), excited (n = 26; 10.1%) and negative-disorganized (n = 54; 21%), thus suggesting a quadripartite structure with both affective and non-affective dimensions. Among non-affective dimensions, negative and disorganization symptoms constituted a unique construct apart from positive symptoms. CONCLUSIONS: Symptom dimensions may represent a useful tool for dissecting the indistinct and non-specific psychopathology of FEP in order to better target specific interventions.
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Authors: Lisa Hochstrasser; Erich Studerus; Anita Riecher-Rössler; Benno G Schimmelmann; Martin Lambert; Undine E Lang; Stefan Borgwardt; Rolf-Dieter Stieglitz; Christian G Huber Journal: Sci Rep Date: 2022-04-22 Impact factor: 4.996
Authors: Mohanbabu Rathnaiah; Elizabeth B Liddle; Lauren Gascoyne; Jyothika Kumar; Mohammad Zia Ul Haq Katshu; Catherine Faruqi; Christina Kelly; Malkeet Gill; Sian Robson; Matt Brookes; Lena Palaniyappan; Peter Morris; Peter F Liddle Journal: Schizophr Bull Open Date: 2020-06-25