University of Amsterdam, Academic Medical Center, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands.
University of Amsterdam, Department of Psychology, Psychological Methods, Nieuwe Achtergracht 129-B, 1018 WT Amsterdam, The Netherlands.
Schizophr Res. 2018 Mar;193:232-239. doi: 10.1016/j.schres.2017.07.035. Epub 2017 Aug 23.
Depressive symptoms occur frequently in patients with schizophrenia. Several factor analytical studies investigated the associations between positive, negative and depressive symptoms and reported difficulties differentiating between these symptom domains. Here, we argue that a network approach may offer insights into these associations, by exploring interrelations between symptoms. The aims of current study were to I) construct a network of positive, negative and depressive symptoms in male patients with schizophrenia to investigate interactions between individual symptoms; II) identify the most central symptoms within this network and III) examine group-level differences in network connectivity between remitted and non-remitted patients. We computed a network of depressive, positive and negative symptoms in a sample of 470 male patients diagnosed with a psychotic disorder. Depressive symptoms were assessed with the Calgary Depression Rating Scale for Schizophrenia, while psychotic symptoms were assessed with the Positive and Negative Syndrome Scale. Networks of male patients who fulfilled remission criteria (Andreasen et al., 2005) and non-remitters for psychosis were compared. Our results indicate that depressive symptoms are mostly associated with suicidality and may act as moderator between psychotic symptoms and suicidality. In addition, 'depressed mood', 'observed depression', 'poor rapport', 'stereotyped thinking' and 'delusions' were central symptoms within the network. Finally, although remitted male patients had a similar network structure compared to non-remitters the networks differed significantly in terms of global strength. In conclusion, clinical symptoms of schizophrenia were linked in a stable way, independent of symptomatic remission while the number of connections appears to be dependent on remission status.
抑郁症状在精神分裂症患者中经常出现。几项因子分析研究调查了阳性、阴性和抑郁症状之间的关联，并报告了在区分这些症状领域方面存在困难。在这里，我们认为网络方法可以通过探索症状之间的相互关系来提供这些关联的见解。本研究的目的是：i）构建精神分裂症男性患者阳性、阴性和抑郁症状的网络，以调查个体症状之间的相互作用；ii）确定该网络中最核心的症状；iii）检查缓解和未缓解患者网络连接的组间差异。我们在 470 名男性精神分裂症患者的样本中计算了抑郁、阳性和阴性症状的网络。抑郁症状用 Calgary 精神分裂症抑郁评定量表进行评估，而精神病症状用阳性和阴性综合征量表进行评估。比较了符合缓解标准（Andreasen 等人，2005）和精神病未缓解的男性患者的网络。我们的结果表明，抑郁症状主要与自杀意念相关，并且可能是精神病症状和自杀意念之间的调节剂。此外，“抑郁情绪”、“观察到的抑郁”、“关系不佳”、“刻板思维”和“妄想”是网络中的核心症状。最后，尽管缓解的男性患者与未缓解的患者具有相似的网络结构，但网络在整体强度方面存在显著差异。总之，精神分裂症的临床症状以一种稳定的方式相互关联，与症状缓解无关，而连接的数量似乎取决于缓解状态。
