Combining dimensional and categorical representation of psychosis: the way forward for DSM-V and ICD-11?

Hdl Handle:
http://hdl.handle.net/10147/128747
Title:
Combining dimensional and categorical representation of psychosis: the way forward for DSM-V and ICD-11?
Authors:
Demjaha, A; Morgan, K; Morgan, C; Landau, S; Dean, K; Reichenberg, A; Sham, P; Fearon, P; Hutchinson, G; Jones, P B; Murray, R M; Dazzan, P
Affiliation:
Division of Psychological Medicine, Institute of Psychiatry, King's College, London, UK. a.demjaha@iop.kcl.ac.uk
Citation:
Combining dimensional and categorical representation of psychosis: the way forward for DSM-V and ICD-11? 2009, 39 (12):1943-55 Psychol Med
Journal:
Psychological medicine
Issue Date:
Dec-2009
URI:
http://hdl.handle.net/10147/128747
DOI:
10.1017/S0033291709990651
PubMed ID:
19627645
Additional Links:
DOI: 10.1017/S0033291709990651
Abstract:
There is good evidence that psychotic symptoms segregate into symptom dimensions. However, it is still unclear how these dimensions are associated with risk indicators and other clinical variables, and whether they have advantages over categorical diagnosis in clinical practice. We investigated symptom dimensions in a first-onset psychosis sample and examined their associations with risk indicators and clinical variables. We then examined the relationship of categorical diagnoses to the same variables.; We recruited 536 patients as part of a population-based, incidence study of psychosis. Psychopathology was assessed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). A principal axis factor analysis was performed on symptom scores. The relationship of dimension scores with risk indicators and with clinical variables was then examined employing regression analyses. Finally, regression models were compared to assess the contribution of dimensions versus diagnosis in explaining these variables.; Factor analysis gave rise to a five-factor solution of manic, reality distortion, negative, depressive and disorganization symptom dimensions. The scores of identified dimensions were differentially associated with specific variables. The manic dimension had the highest number of significant associations; strong correlations were observed with shorter duration of untreated psychosis, acute mode of onset and compulsory admission. Adding dimensional scores to diagnostic categories significantly increased the amount of variability explained in predicting these variables; the reverse was also true but to a lesser extent.; Categorical and dimensional representations of psychosis are complementary. Using both appears to be a promising strategy in conceptualising psychotic illnesses.
Language:
en
MeSH:
Adolescent; Adult; Comorbidity; Cross-Sectional Studies; Diagnostic and Statistical Manual of Mental Disorders; Factor Analysis, Statistical; Female; Humans; Incidence; Intelligence; International Classification of Diseases; Male; Marijuana Abuse; Middle Aged; Patient Admission; Psychiatric Status Rating Scales; Psychometrics; Psychopathology; Psychotic Disorders; Risk Factors; Social Behavior; Young Adult
ISSN:
1469-8978

Full metadata record

DC FieldValue Language
dc.contributor.authorDemjaha, Aen
dc.contributor.authorMorgan, Ken
dc.contributor.authorMorgan, Cen
dc.contributor.authorLandau, Sen
dc.contributor.authorDean, Ken
dc.contributor.authorReichenberg, Aen
dc.contributor.authorSham, Pen
dc.contributor.authorFearon, Pen
dc.contributor.authorHutchinson, Gen
dc.contributor.authorJones, P Ben
dc.contributor.authorMurray, R Men
dc.contributor.authorDazzan, Pen
dc.date.accessioned2011-04-27T11:29:04Z-
dc.date.available2011-04-27T11:29:04Z-
dc.date.issued2009-12-
dc.identifier.citationCombining dimensional and categorical representation of psychosis: the way forward for DSM-V and ICD-11? 2009, 39 (12):1943-55 Psychol Meden
dc.identifier.issn1469-8978-
dc.identifier.pmid19627645-
dc.identifier.doi10.1017/S0033291709990651-
dc.identifier.urihttp://hdl.handle.net/10147/128747-
dc.description.abstractThere is good evidence that psychotic symptoms segregate into symptom dimensions. However, it is still unclear how these dimensions are associated with risk indicators and other clinical variables, and whether they have advantages over categorical diagnosis in clinical practice. We investigated symptom dimensions in a first-onset psychosis sample and examined their associations with risk indicators and clinical variables. We then examined the relationship of categorical diagnoses to the same variables.-
dc.description.abstractWe recruited 536 patients as part of a population-based, incidence study of psychosis. Psychopathology was assessed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). A principal axis factor analysis was performed on symptom scores. The relationship of dimension scores with risk indicators and with clinical variables was then examined employing regression analyses. Finally, regression models were compared to assess the contribution of dimensions versus diagnosis in explaining these variables.-
dc.description.abstractFactor analysis gave rise to a five-factor solution of manic, reality distortion, negative, depressive and disorganization symptom dimensions. The scores of identified dimensions were differentially associated with specific variables. The manic dimension had the highest number of significant associations; strong correlations were observed with shorter duration of untreated psychosis, acute mode of onset and compulsory admission. Adding dimensional scores to diagnostic categories significantly increased the amount of variability explained in predicting these variables; the reverse was also true but to a lesser extent.-
dc.description.abstractCategorical and dimensional representations of psychosis are complementary. Using both appears to be a promising strategy in conceptualising psychotic illnesses.-
dc.language.isoenen
dc.relation.urlDOI: 10.1017/S0033291709990651en
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshComorbidity-
dc.subject.meshCross-Sectional Studies-
dc.subject.meshDiagnostic and Statistical Manual of Mental Disorders-
dc.subject.meshFactor Analysis, Statistical-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshIncidence-
dc.subject.meshIntelligence-
dc.subject.meshInternational Classification of Diseases-
dc.subject.meshMale-
dc.subject.meshMarijuana Abuse-
dc.subject.meshMiddle Aged-
dc.subject.meshPatient Admission-
dc.subject.meshPsychiatric Status Rating Scales-
dc.subject.meshPsychometrics-
dc.subject.meshPsychopathology-
dc.subject.meshPsychotic Disorders-
dc.subject.meshRisk Factors-
dc.subject.meshSocial Behavior-
dc.subject.meshYoung Adult-
dc.titleCombining dimensional and categorical representation of psychosis: the way forward for DSM-V and ICD-11?en
dc.contributor.departmentDivision of Psychological Medicine, Institute of Psychiatry, King's College, London, UK. a.demjaha@iop.kcl.ac.uken
dc.identifier.journalPsychological medicineen
dc.description.provinceLeinster-

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