Dimensional psychopathology of schizophrenia: SVARAD dimensional profiles in an acute inpatient sample

Abstract

Objective: This study aimed at describing the dimensional profile of schizophrenia in an acute inpatient sample, and at exploring the different components of psychopathological suffering within this single diagnostic category according to a dimensional perspective.

Methods: The sample consisted of 81 schizophrenic patients consecutively admitted to a psychiatric inpatient care unit. Each patient was administered the rapid dimensional assessment scale SVARAD (acronym for the Italian name “Scala per la VAlutazione RApida Dimensionale”) and the Global Assessment of Functioning scale. Dimensional profiles were obtained from mean scores on each SVARAD item. Analysis of variance was used to test for differences between groups in mean SVARAD item scores.

Results: The findings indicated that age, sex, psychosocial functioning, involuntary nature of the admission, and predominance of positive or disorganisation symptomatology are associated with differences in the mean dimensional profile. Also, sizable subgroups of patients with clinically significant levels of psychopathological dimensions (e.g., Sadness/Demoralisation, Anger/Aggressiveness, Impulsivity) that have limited overlap with the traditionally acknowledged domains of positive symptoms, negative symptoms, and disorganisation, were identified. No differences in any psychopathological dimension were found between the classical schizophrenia subtypes.

Conclusions: The dimensional assessment with SVARAD helps appreciate the singularity of each patient within the same diagnostic category. The study suggests that recognising different dimensional profiles with the SVARAD may allow more personalised choices of treatment.