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Psychopathological dimensions in schizophrenia

M J Cuesta1, V Peralta

  • 1Psychiatric Unit of Virgen del Camino Hospital, Pamplona, Spain.

Schizophrenia Bulletin
|January 1, 1995
PubMed
Summary
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This study challenges the traditional positive and negative symptom model in schizophrenia, finding that three or four dimensions, including "disorder of relating" and "disorganization," better explain patient symptoms on the Positive and Negative Syndrome Scale (PANSS).

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Psychometrics

Background:

  • The Positive and Negative Syndrome Scale (PANSS) is widely used to assess schizophrenia symptoms.
  • The traditional positive and negative symptom construct in schizophrenia lacks robust empirical support.
  • Understanding latent syndromes is crucial for accurate diagnosis and treatment of schizophrenia.

Purpose of the Study:

  • To investigate the underlying latent syndromes of schizophrenia using the PANSS.
  • To evaluate the confirmatory factor analysis of different dimensional models of schizophrenia symptomatology.
  • To determine if the positive and negative symptom construct is adequately supported by empirical data.

Main Methods:

  • A sample of 100 patients diagnosed with DSM-III-R schizophrenia was recruited.

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  • Semistructured interviews were conducted for schizophrenia assessment.
  • Confirmatory factor analysis was employed to test various dimensional models of PANSS symptoms.

    • Main Results:

    • The study did not confirm the traditional one- or two-dimension positive and negative symptom construct.
    • Three- and four-dimension models demonstrated a higher goodness of fit compared to simpler models.
    • These better-fitting models included dimensions of "disorder of relating" and "disorganization" alongside positive and negative syndromes.

    Conclusions:

    • The findings suggest that schizophrenia symptomatology is better represented by more complex dimensional models.
    • "Disorder of relating" encompasses emotional withdrawal and passive/apathetic social withdrawal.
    • The "disorganization" dimension includes conceptual disorganization, poor attention, and inappropriately affects, suggesting the latter be added to the PANSS.