General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Institute of Psychology, Faculty of Social and Political Science, University of Lausanne, Switzerland.
General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Schizophr Res. 2022 Aug;246:126-131. doi: 10.1016/j.schres.2022.06.019. Epub 2022 Jun 28.
The factorial structure of schizophrenia symptoms has been much debated but little is known on its degree of unicity, specificity as well as its dynamic over time. Symptom differentiation is a phenomenon according to which patients' symptoms could differentiate from one another during illness to form more independent, distinct dimensions. On the contrary, symptom dedifferentiation is an increase in the correlations between those symptoms over time. The goal of this study was to investigate symptom differentiation or dedifferentiation over time in recent onset psychosis using the Positive and Negative Syndrome Scale.
A confirmatory factor analysis model based on the consensus five-factor model of the Positive and Negative Syndrome Scale for schizophrenia was estimated on seven different time points over a three-year period. A general factor capturing common variance between every symptom was also included. Explained common variance was computed for the general factor and each specific factor.
Three hundred and sixty-two recent onset psychosis patients were assessed. Results showed no evidence for either symptom differentiation or dedifferentiation over time. Specific symptoms accounted for >70 % of the variance suggesting a high degree of specificity of the symptomatology.
Overall, this study adds support for a highly multidimensional approach to clinical symptom assessment with an explicit focus on depression. The premise behind the staging approach being inherently one-dimensional, implications for further research is discussed.
精神分裂症症状的因子结构一直存在争议，但对其独特性、特异性以及随时间的动态变化知之甚少。症状分化是一种现象，即患者的症状在患病期间可能彼此分化，形成更独立、更明显的维度。相反，症状去分化是指随着时间的推移，这些症状之间的相关性增加。本研究的目的是使用阳性和阴性症状量表（Positive and Negative Syndrome Scale），调查精神分裂症发病初期的症状随时间的分化或去分化。
基于精神分裂症阳性和阴性症状量表共识五因子模型，在三年期间的七个不同时间点上估计了一个验证性因子分析模型。还包括一个捕捉每个症状之间共同方差的总因子。计算了总因子和每个特定因子的解释共同方差。
评估了 362 名精神分裂症发病初期患者。结果表明，症状没有随时间分化或去分化的证据。特定症状占方差的>70%，表明症状学具有高度特异性。
总的来说，这项研究支持对临床症状评估采用高度多维的方法，并明确关注抑郁。讨论了分期方法背后的前提是内在的一维性，对进一步研究的影响。
Zotero 插件