Julia C. C. Schulte-Strathaus, Christian Rauschenberg, Isabell Paetzold, Diego Quattrone, Jessica Hartmann, Paul Amminger, Hok Pan Yuen, Patrick D. McGorry, Barnaby Nelson, Ulrich Reininghaus
{"title":"精神病超高风险个体的跨诊断症状维度:多能性风险的维度表征","authors":"Julia C. C. Schulte-Strathaus, Christian Rauschenberg, Isabell Paetzold, Diego Quattrone, Jessica Hartmann, Paul Amminger, Hok Pan Yuen, Patrick D. McGorry, Barnaby Nelson, Ulrich Reininghaus","doi":"10.1111/eip.70086","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Intro</h3>\n \n <p>Research has shifted focus from categorical to dimensional conceptualisations of mental health conditions. This is supported by high overlap between disorders, particularly psychosis spectrum and affective disorders, which cuts across traditional diagnostic boundaries. While there is evidence for a general factor of psychopathology in individuals with schizophrenia, schizoaffective disorder, and psychotic bipolar I disorder, transdiagnostic dimensions of psychopathology have not been investigated in young individuals at ultra-high risk for psychosis, that is, youth with pluripotent symptom patterns preceding first-episode psychosis. The current study sought to investigate (1) whether there is a general dimension underlying psychopathological symptoms in individuals and (2) whether the formation of specific symptom dimensions (i.e., positive symptoms, negative symptoms, affect, and activation) is justified alongside a general dimension.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Item factor analyses were conducted on symptom ratings of the Brief Psychiatric Rating Scale at baseline in the Staged Treatment in Early Psychosis (STEP) trial.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>In total, 342 UHR participants were included. A bifactor model with one general symptom dimension and four specific factors (positive symptoms, negative symptoms, affect, and activation) yielded the best relative model fit and interpretability when compared to uni- and multidimensional models, albeit absolute model fit statistics provided no strong evidence to support this finding. However, model stability and interpretability tentatively suggest it can help tell apart pluripotent and domain-specific symptom patterns.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Findings cautiously suggest that the BPRS may index both a general dimension and several more specific dimensions, reflecting pluripotency underlying psychological features in the sample. A ‘common ground’ across the risk syndrome in this heterogeneous sample, with various comorbidities, would lend further evidence to support the notion of a transdiagnostic phenotype in youth.</p>\n </section>\n </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"19 8","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/eip.70086","citationCount":"0","resultStr":"{\"title\":\"Transdiagnostic Symptom Dimensions in Individuals at Ultra-High Risk for Psychosis: Towards Dimensional Representations of Pluripotent Risk\",\"authors\":\"Julia C. C. Schulte-Strathaus, Christian Rauschenberg, Isabell Paetzold, Diego Quattrone, Jessica Hartmann, Paul Amminger, Hok Pan Yuen, Patrick D. McGorry, Barnaby Nelson, Ulrich Reininghaus\",\"doi\":\"10.1111/eip.70086\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Intro</h3>\\n \\n <p>Research has shifted focus from categorical to dimensional conceptualisations of mental health conditions. This is supported by high overlap between disorders, particularly psychosis spectrum and affective disorders, which cuts across traditional diagnostic boundaries. While there is evidence for a general factor of psychopathology in individuals with schizophrenia, schizoaffective disorder, and psychotic bipolar I disorder, transdiagnostic dimensions of psychopathology have not been investigated in young individuals at ultra-high risk for psychosis, that is, youth with pluripotent symptom patterns preceding first-episode psychosis. The current study sought to investigate (1) whether there is a general dimension underlying psychopathological symptoms in individuals and (2) whether the formation of specific symptom dimensions (i.e., positive symptoms, negative symptoms, affect, and activation) is justified alongside a general dimension.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Item factor analyses were conducted on symptom ratings of the Brief Psychiatric Rating Scale at baseline in the Staged Treatment in Early Psychosis (STEP) trial.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>In total, 342 UHR participants were included. A bifactor model with one general symptom dimension and four specific factors (positive symptoms, negative symptoms, affect, and activation) yielded the best relative model fit and interpretability when compared to uni- and multidimensional models, albeit absolute model fit statistics provided no strong evidence to support this finding. However, model stability and interpretability tentatively suggest it can help tell apart pluripotent and domain-specific symptom patterns.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Findings cautiously suggest that the BPRS may index both a general dimension and several more specific dimensions, reflecting pluripotency underlying psychological features in the sample. 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Transdiagnostic Symptom Dimensions in Individuals at Ultra-High Risk for Psychosis: Towards Dimensional Representations of Pluripotent Risk
Intro
Research has shifted focus from categorical to dimensional conceptualisations of mental health conditions. This is supported by high overlap between disorders, particularly psychosis spectrum and affective disorders, which cuts across traditional diagnostic boundaries. While there is evidence for a general factor of psychopathology in individuals with schizophrenia, schizoaffective disorder, and psychotic bipolar I disorder, transdiagnostic dimensions of psychopathology have not been investigated in young individuals at ultra-high risk for psychosis, that is, youth with pluripotent symptom patterns preceding first-episode psychosis. The current study sought to investigate (1) whether there is a general dimension underlying psychopathological symptoms in individuals and (2) whether the formation of specific symptom dimensions (i.e., positive symptoms, negative symptoms, affect, and activation) is justified alongside a general dimension.
Methods
Item factor analyses were conducted on symptom ratings of the Brief Psychiatric Rating Scale at baseline in the Staged Treatment in Early Psychosis (STEP) trial.
Results
In total, 342 UHR participants were included. A bifactor model with one general symptom dimension and four specific factors (positive symptoms, negative symptoms, affect, and activation) yielded the best relative model fit and interpretability when compared to uni- and multidimensional models, albeit absolute model fit statistics provided no strong evidence to support this finding. However, model stability and interpretability tentatively suggest it can help tell apart pluripotent and domain-specific symptom patterns.
Conclusion
Findings cautiously suggest that the BPRS may index both a general dimension and several more specific dimensions, reflecting pluripotency underlying psychological features in the sample. A ‘common ground’ across the risk syndrome in this heterogeneous sample, with various comorbidities, would lend further evidence to support the notion of a transdiagnostic phenotype in youth.
期刊介绍:
Early Intervention in Psychiatry publishes original research articles and reviews dealing with the early recognition, diagnosis and treatment across the full range of mental and substance use disorders, as well as the underlying epidemiological, biological, psychological and social mechanisms that influence the onset and early course of these disorders. The journal provides comprehensive coverage of early intervention for the full range of psychiatric disorders and mental health problems, including schizophrenia and other psychoses, mood and anxiety disorders, substance use disorders, eating disorders and personality disorders. Papers in any of the following fields are considered: diagnostic issues, psychopathology, clinical epidemiology, biological mechanisms, treatments and other forms of intervention, clinical trials, health services and economic research and mental health policy. Special features are also published, including hypotheses, controversies and snapshots of innovative service models.