Structure of schizophrenic symptomatology and its changes over time: prospective factor-analytical study

A representative sample of 156 new schizophrenic patients (DSM-III) were examined at the time of their first treatment contact for psychosis, and re-examined 2 and 5 years thereafter. The symptom variables, assessed by the Comprehensive Psychopathological Rating Scale (CPRS), were factored and compared with each other. The following major dimensions were found: (i) a fairly stable negative dimension with effective and speech impoverishment and withdrawal; (ii) a delusional dimension; (iii) hallucinatory dimensions; (iv) a disorganization dimension; and (v) a depressive dimension with unreal experiences. The negative dimension was more prevalent in unmarried patients. Neither the two-syndrome model of negative and positive symptoms nor the three-syndrome model of psychomotor poverty, disorganization and reality distortion proved to be satisfactory. In a representative sample of schizophrenic patients, the syndrome structure described by symptom dimensions appears to be more complex and varies considerably according to the duration of the illness.