Cardno Alastair G, Allardyce Judith, Bakker Steven C, Toulopoulou Timothea, Kravariti Eugenia, Picchioni Marco M, Kane Fergus, Rijsdijk Frühling V, Mahmood Tariq, Nasser El Din Soumaya, du Toit Deline, Jones Lisa A, Quattrone Diego, Walters James T R, Legge Sophie E, Holmans Peter A, Murray Robin M, Vassos Evangelos
Division of Psychological and Social Medicine, University of Leeds, Leeds, UK.
Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Br J Psychiatry. 2025 Jan;226(1):16-23. doi: 10.1192/bjp.2024.129.
Positive, negative and disorganised psychotic symptom dimensions are associated with clinical and developmental variables, but differing definitions complicate interpretation. Additionally, some variables have had little investigation.
To investigate associations of psychotic symptom dimensions with clinical and developmental variables, and familial aggregation of symptom dimensions, in multiple samples employing the same definitions.
We investigated associations between lifetime symptom dimensions and clinical and developmental variables in two twin and two general psychosis samples. Dimension symptom scores and most other variables were from the Operational Criteria Checklist. We used logistic regression in generalised linear mixed models for combined sample analysis ( = 875 probands). We also investigated correlations of dimensions within monozygotic (MZ) twin pairs concordant for psychosis ( = 96 pairs).
Higher symptom scores on all three dimensions were associated with poor premorbid social adjustment, never marrying/cohabiting and earlier age at onset, and with a chronic course, most strongly for the negative dimension. The positive dimension was also associated with Black and minority ethnicity and lifetime cannabis use; the negative dimension with male gender; and the disorganised dimension with gradual onset, lower premorbid IQ and substantial within twin-pair correlation. In secondary analysis, disorganised symptoms in MZ twin probands were associated with lower premorbid IQ in their co-twins.
These results confirm associations that dimensions share in common and strengthen the evidence for distinct associations of co-occurring positive symptoms with ethnic minority status, negative symptoms with male gender and disorganised symptoms with substantial familial influences, which may overlap with influences on premorbid IQ.
阳性、阴性和紊乱性精神病症状维度与临床及发育变量相关，但不同的定义使解读变得复杂。此外，一些变量几乎未被研究。
在采用相同定义的多个样本中，研究精神病症状维度与临床及发育变量的关联，以及症状维度的家族聚集性。
我们在两个双胞胎样本和两个普通精神病样本中，研究了终生症状维度与临床及发育变量之间的关联。维度症状得分及大多数其他变量来自《操作标准清单》。我们在广义线性混合模型中使用逻辑回归进行合并样本分析（共875名先证者）。我们还研究了同患精神病的单卵双胞胎对（共96对）中各维度之间的相关性。
所有三个维度上较高的症状得分都与病前社会适应不良、从未结婚/同居以及发病年龄较早相关，且与慢性病程相关，对阴性维度的影响最为强烈。阳性维度还与黑人及少数族裔以及终生使用大麻有关；阴性维度与男性性别有关；紊乱维度与起病缓慢、病前智商较低以及双胞胎对之间的显著相关性有关。在二次分析中，单卵双胞胎先证者中的紊乱症状与其同卵双胞胎的病前智商较低有关。
这些结果证实了各维度共有的关联，并加强了以下证据：同时出现的阳性症状与少数族裔身份、阴性症状与男性性别以及紊乱症状与显著的家族影响之间存在独特关联，这些影响可能与对病前智商的影响重叠。
