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. 2019 Dec;13(6):1431-1438.
doi: 10.1111/eip.12789. Epub 2019 Jan 15.

Dimensional structure of first episode psychosis

Matteo Tonna  1 , Paolo Ossola  1 , Carlo Marchesi  1 , Elena Bettini  1 , Antonio Lasalvia  2 , Chiara Bonetto  3 , Jacopo Lenzi  4 , Paola Rucci  4 , Laura Iozzino  3 , Massimo Cellini  5 , Carla Comacchio  3 , Doriana Cristofalo  3 , Armando D'Agostino  6 , Giovanni de Girolamo  7 , Katia De Santi  2 , Daniela Ghigi  8 , Emanuela Leuci  9 , Maurizio Miceli  5 , Anna Meneghelli  10 , Francesca Pileggi  11 , Silvio Scarone  6 , Paolo Santonastaso  12 , Stefano Torresani  13 , Sarah Tosato  3 , Angela Veronese  12 , Angelo Fioritti  11 , Mirella Ruggeri  2   3 ; GET UP Group
Affiliations

Dimensional structure of first episode psychosis

Matteo Tonna et al. Early Interv Psychiatry. 2019 Dec.

Abstract

Aim: Current diagnostic systems, DSM-5 and ICD-10, still adopt a categorical approach to classify psychotic disorders. The present study was aimed at investigating the structure of psychotic symptomatology in both affective and non-affective psychosis from a dimensional approach.

Methods: Participants with a first episode psychosis (FEP) were recruited from a cluster-randomized controlled trial (GET-UP PIANO TRIAL), offered to all Community Mental Health Centres (CMHCs) located across two northern Italian regions. After clinical stabilization, patients were assessed with a comprehensive set of psychopathological measures including the Positive and Negative Syndrome Scale, the Hamilton Depression Rating Scale and the Bech-Rafaelsen Mania Rating Scale. A two-step cluster analysis was performed.

Results: Overall, 257 FEP patients (male, n = 171, 66.5%; mean age = 24.96 ± 4.56) were included in the study. The cluster analysis revealed a robust four-cluster solution: delusional-persecutory (n = 82; 31.9%), depressed (n = 95; 37%), excited (n = 26; 10.1%) and negative-disorganized (n = 54; 21%), thus suggesting a quadripartite structure with both affective and non-affective dimensions. Among non-affective dimensions, negative and disorganization symptoms constituted a unique construct apart from positive symptoms.

Conclusions: Symptom dimensions may represent a useful tool for dissecting the indistinct and non-specific psychopathology of FEP in order to better target specific interventions.

Keywords: affective symptoms; dimension; first episode psychosis; negative symptoms; positive symptoms.

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References

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