TY - JOUR
T1 - Transdiagnostic dimensions of psychosis in the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP)
AU - Reininghaus, Ulrich
AU - Böhnke, Jan R.
AU - Chavez-Baldini, Un Young
AU - Gibbons, Robert
AU - Ivleva, Elena
AU - Clementz, Brett A.
AU - Pearlson, Godfrey D.
AU - Keshavan, Matcheri S.
AU - Sweeney, John A
AU - Tamminga, Carol A.
N1 - Funding Information:
U. Reininghaus and J.R. Böhnke contributed to this work as joint first authors. The study was supported by the Netherlands Organization for Scientific Research (NOW) Veni grant 451-13-022 and the US National Institute of Mental Health (NIMH) grants MH-077851, MH-078113, MH-077945, MH-077852 and MH-077862. The authors thank B. Witte and G. Poudyal for their contributions to data management, which allowed for seamless analysis and inspection of all B-SNIP data resources, and the patient and family volunteers who joined the study and contributed their time and individual data.
Publisher Copyright:
© 2019 World Psychiatric Association
PY - 2019/2
Y1 - 2019/2
N2 - The validity of the classification of non-affective and affective psychoses as distinct entities has been disputed, but, despite calls for alternative approaches to defining psychosis syndromes, there is a dearth of empirical efforts to identify transdiagnostic phenotypes of psychosis. We aimed to investigate the validity and utility of general and specific symptom dimensions of psychosis cutting across schizophrenia, schizoaffective disorder and bipolar I disorder with psychosis. Multidimensional item-response modeling was conducted on symptom ratings of the Positive and Negative Syndrome Scale, Young Mania Rating Scale, and Montgomery-Åsberg Depression Rating Scale in the multicentre Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium, which included 933 patients with a diagnosis of schizophrenia (N=397), schizoaffective disorder (N=224), or bipolar I disorder with psychosis (N=312). A bifactor model with one general symptom dimension, two distinct dimensions of non-affective and affective psychosis, and five specific symptom dimensions of positive, negative, disorganized, manic and depressive symptoms provided the best model fit. There was further evidence on the utility of symptom dimensions for predicting B-SNIP psychosis biotypes with greater accuracy than categorical DSM diagnoses. General, positive, negative and disorganized symptom dimension scores were higher in African American vs. Caucasian patients. Symptom dimensions accurately classified patients into categorical DSM diagnoses. This study provides evidence on the validity and utility of transdiagnostic symptom dimensions of psychosis that transcend traditional diagnostic boundaries of psychotic disorders. Findings further show promising avenues for research at the interface of dimensional psychopathological phenotypes and basic neurobiological dimensions of psychopathology.
AB - The validity of the classification of non-affective and affective psychoses as distinct entities has been disputed, but, despite calls for alternative approaches to defining psychosis syndromes, there is a dearth of empirical efforts to identify transdiagnostic phenotypes of psychosis. We aimed to investigate the validity and utility of general and specific symptom dimensions of psychosis cutting across schizophrenia, schizoaffective disorder and bipolar I disorder with psychosis. Multidimensional item-response modeling was conducted on symptom ratings of the Positive and Negative Syndrome Scale, Young Mania Rating Scale, and Montgomery-Åsberg Depression Rating Scale in the multicentre Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium, which included 933 patients with a diagnosis of schizophrenia (N=397), schizoaffective disorder (N=224), or bipolar I disorder with psychosis (N=312). A bifactor model with one general symptom dimension, two distinct dimensions of non-affective and affective psychosis, and five specific symptom dimensions of positive, negative, disorganized, manic and depressive symptoms provided the best model fit. There was further evidence on the utility of symptom dimensions for predicting B-SNIP psychosis biotypes with greater accuracy than categorical DSM diagnoses. General, positive, negative and disorganized symptom dimension scores were higher in African American vs. Caucasian patients. Symptom dimensions accurately classified patients into categorical DSM diagnoses. This study provides evidence on the validity and utility of transdiagnostic symptom dimensions of psychosis that transcend traditional diagnostic boundaries of psychotic disorders. Findings further show promising avenues for research at the interface of dimensional psychopathological phenotypes and basic neurobiological dimensions of psychopathology.
KW - Psychosis
KW - biotypes
KW - bipolar disorder with psychosis
KW - general symptom dimensions
KW - schizoaffective disorder
KW - schizophrenia
KW - specific symptom dimensions
KW - transdiagnostic phenotypes
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U2 - 10.1002/wps.20607
DO - 10.1002/wps.20607
M3 - Article
C2 - 30600629
AN - SCOPUS:85059382226
SN - 1723-8617
VL - 18
SP - 67
EP - 76
JO - World Psychiatry
JF - World Psychiatry
IS - 1
ER -