Kopelowicz Alex, Ventura Joseph, Liberman Robert Paul, Mintz Jim
David Geffen School of Medicine at University of California, Los Angeles, CA, USA.
Psychopathology. 2008;41(2):77-84. doi: 10.1159/000111551. Epub 2007 Nov 23.
The Brief Psychiatric Rating Scale (BPRS) has been the workhorse of psychopathology assessment in studies of schizophrenia and related psychotic disorders for over 40 years. Our goal was to evaluate the discriminant validity of the BPRS across the broad spectrum of persons with schizophrenia.
The total sample of 565 subjects with schizophrenia (84%) or schizoaffective disorder (16%) came from eight separate studies conducted under the aegis of the UCLA Clinical Research Center for Schizophrenia and Psychiatric Rehabilitation over a period of 15 years. The total sample could be divided into three subsamples based on illness chronicity and degree of refractoriness to treatment: Recent-onset patients had been ill for less than 2 years (n = 178), stable chronic patients between 2 and 19 years (n = 243) and treatment-refractory patients for more than 19 years (n = 144). Exploratory principal components analysis and varimax rotation were performed on the total sample. The results of each of the three subsamples were compared to the total sample using a correlation matrix and by calculating a coefficient of congruence.
A 4-factor solution was considered the most interpretable for each subsample, reflecting the same 4 components identified in the total sample: positive symptoms, negative symptoms, agitation-mania and depression-anxiety. Correlation coefficients and coefficient of congruence were very high, ranging from 0.91 to 0.98.
The consistency of the 4-factor solution of the 24-item BPRS across the range of subjects, from first psychotic episode to long-stay, institutionalized patients, supports the use of these factors and this instrument as a whole to track changes over time and with treatment in research and clinical samples.
在超过40年的精神分裂症及相关精神障碍研究中，简明精神病评定量表（BPRS）一直是精神病理学评估的主要工具。我们的目标是评估BPRS在广泛的精神分裂症患者群体中的判别效度。
565名患有精神分裂症（84%）或分裂情感性障碍（16%）的受试者样本来自于在加州大学洛杉矶分校精神分裂症与精神疾病康复临床研究中心主持下，历经15年开展的八项独立研究。根据疾病慢性程度和治疗难治程度，总样本可分为三个子样本：近期发病患者患病时间少于2年（n = 178），病情稳定的慢性患者患病时间在2至19年之间（n = 243），治疗难治性患者患病时间超过19年（n = 144）。对总样本进行探索性主成分分析和方差最大化旋转。使用相关矩阵并计算一致性系数，将三个子样本各自的结果与总样本进行比较。
对于每个子样本，四因素解决方案被认为是最具可解释性的，反映了在总样本中识别出的相同四个成分：阳性症状、阴性症状、激越-躁狂和抑郁-焦虑。相关系数和一致性系数非常高，范围从0.91至0.98。
24项BPRS的四因素解决方案在从首次精神病发作到长期住院的机构化患者等各类受试者中具有一致性，这支持了在研究和临床样本中使用这些因素以及整个该工具来追踪随时间和治疗而发生的变化。
