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Patterns of Positive and Negative Symptoms in First Episode Schizophrenia

Published online by Cambridge University Press:  02 January 2018

José Luis Vázquez-Barquero ,
Ismael Lastra ,
Ma Jesús Cuesta Nuñez ,
Sara Herrera Castanedo  and
Graham Dunn
José Luis Vázquez-Barquero*
Affiliation:
Clinical and Social Psychiatry Research Unit, Department of Psychiatry, University Hospital “Marqués de Valdecilla” University of Cantabria, Santander
Ismael Lastra
Affiliation:
Clinical and Social Psychiatry Research Unit, Department of Psychiatry, University Hospital “Marqués de Valdecilla” University of Cantabria, Santander
Ma Jesús Cuesta Nuñez
Affiliation:
Clinical and Social Psychiatry Research Unit, Department of Psychiatry, University Hospital “Marqués de Valdecilla” University of Cantabria, Santander
Sara Herrera Castanedo
Affiliation:
Clinical and Social Psychiatry Research Unit, Department of Psychiatry, University Hospital “Marqués de Valdecilla” University of Cantabria, Santander
Graham Dunn
Affiliation:
Department of Biostatistics and Computing, Institute of Psychiatry, London SE5 8AF
*
Professor J. L. Vázquez-Barquero, Unidad de Investigación en Psiquiatría Clínica y Social, Hospital Universitario “Marqués de Valdecilla”, Av. Valdecilla s/n, Santander 39008, Spain
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Abstract

Background

The aim is to examine, in first episodes of schizophrenia the appropriateness of the simple two-dimensional model of schizophrenia (‘negative’ and ‘positive’ dimensions) and more complex variants.

Method

All patients with a first episode of schizophrenia who, over a two-year period, made contact with any of the public mental health services of the autonomous region of Cantabria in northern Spain were investigated. The psychiatric evaluation included, among other instruments, the Present State Examination (PSE–9), and the scales for the assessment of the ‘positive’ and ‘negative’ symptoms of schizophrenia (SAPS and SANS respectively). The dimensionality of the SAPS/SANS item scores and sub-scales was examined through the use of principal component analysis.

Results

The principal component solution that best fits the data obtained with the initial SANS/SAPS sub-scales reflects the existence of three different (‘negative’ ‘positive’, ‘disorganisation’) factors. The strategy adopted of repeating the analysis after extracting the principal components of the original sub-scales, revealed that although the nature and item composition of the initial ‘negative’ and ‘disorganisation’ factors were in general confirmed, the ‘positive’ dimension presented a more complex structure with at least two ‘positive’ (‘Non-Paranoid’ and ‘Paranoid’) independent factors.

Conclusion

The psychopathological structure of the early stages of schizophrenia, as evaluated by the SANS/SAPS, is characterised by the presence of four dimensions: two ‘positive’, one ‘negative’ and one ‘disorganisation‘.

Type
Papers
Information
The British Journal of Psychiatry , Volume 168 , Issue 6 , June 1996 , pp. 693 - 701
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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References

Andreasen, N. C. (1982) Negative symptoms in schizophrenia. Definition and reliability. Archives of General Psychiatry, 39, 784–788.Google Scholar
Andreasen, N. C. (1983) The Scale for the Assessment of Negative Symptoms (SANS). Iowa City: The University of Iowa.Google Scholar
Andreasen, N. C. (1984) The Scale for the Assessment of Positive Symptoms (SAPS). Iowa City: The University of Iowa.Google Scholar
Andreasen, N. C. & Olsen, S. (1982) Negative and positive schizophrenia: definition and validation. Archives of General Psychiatry, 39, 789–794.Google Scholar
Arndt, S., Alliger, R. J. & Andreasen, N. C. (1991) The distinction of positive and negative symptoms. The failure of a two-dimensional model. British Journal of Psychiatry, 158, 317–322.Google Scholar
Crow, T. J. (1980) Molecular pathology of schizophrenia: more than a disease process? British Medical Journal, 280, 66–68.CrossRefGoogle ScholarPubMed
De Leon, J., Peralta, V. & Cuesta, M. J. (1993) Negative symptoms and emotional blunting in schizophrenic patients. Journal of Clinical Psychiatry, 54, 103–108.Google ScholarPubMed
Dunn, G., Sham, P. & Hand, D. (1993) Statistics and the nature of depression. Psychological Medicine, 23, 871–889.Google Scholar
Gittelman-Klein, R. & Klein, D. F. (1969) Premorbid asocial adjustment and prognosis in schizophrenia. Journal of Psychiatric Research, 7, 35–53.Google Scholar
Goldstein, M. J. (1978) Further data concerning the relation between premorbid adjustment and paranoid symptomatology. Schizophrenia Bulletin, 4, 236–243.CrossRefGoogle ScholarPubMed
Gur, R. E., Mozley, P. D., Resnick, S. M., et al (1991) Relations among clinical scales in schizophrenia. American Journal of Psychiatry, 148, 472–478.Google Scholar
Keefe, R. S. E., Harvey, P. D., Lenzenweger, M. F., et al (1992) Empirical assessment of the factorial structure of clinical symptoms in schizophrenia: Negative symptoms. Psychiatry Research, 44, 153–165.CrossRefGoogle ScholarPubMed
Liddle, P. F. (1987) The symptoms of chronic schizophrenia: a reexamination of the positive-negative dichotomy. British Journal of Psychiatry, 151, 145–151.Google Scholar
Malla, A. K., Norman, R. M. G., Williamson, P., et al (1993) Three syndrome concept of schizophrenia. A factor analytic study. Schizophrenia Research, 10, 143–150.Google Scholar
Miller, D. D., Arndt, S. & Andreasen, N. C. (1993) Alogia, attentional impairment, and inappropriate affect: Their status in the dimension of schizophrenia. Comprehensive Psychiatry, 34, 221–226.CrossRefGoogle ScholarPubMed
Obiols, J. E., Salvador, L., Humbert, M., et al (1985) Evaluatión de los síntomas negativos de la esquizofrenia. Revista Departamento de Psiquiatría Facultad de Medicina de Barcelona, 12, 85–91.Google Scholar
Peralta, V., De Leon, J. & Cuesta, M. J. (1992) Are there more than two syndromes in schizophrenia? A critique of the positive-negative dichotomy. British Journal of Psychiatry, 161, 335–343.Google Scholar
Peralta, V., Cuesta, M. J. & De Leon, J. (1994) An empirical analysis of latent structures underlying schizophrenic symptoms: A four-syndrome model. Biological Psychiatry, 36, 726–736.CrossRefGoogle ScholarPubMed
Salvador, L., Obiols, J. E., Humbert, M., et al (1985) Evaluación de los síntomas positivos de la esquizofrenia. Revista Departamento de Psiquiatría Facultad de Medicina de Barcelona, 12, 92–102.Google Scholar
Shtasel, D. L., Gur, R. E., Gallacher, F., et al (1992) Phenomenology and functioning in first-episode schizophrenia. Schizophrenia Bulletin, 18, 449–461.Google Scholar
Silver, H., David, D., Kaplan, M., et al (1993) Factor analysis of schizophrenic symptoms and comparison of different rating scales. Schizophrenia Research, 10, 67–75.Google Scholar
SPSS (1993) SPSS for Windows. Release 6.0. Chicago: SPSS Inc.Google Scholar
Thompson, P. A. & Meltzer, H. Y. (1993) Positive, negative, and disorganisation factors from the Schedule for Affective Disorders and Schizophrenia and the Present State Examination. A three-factor solution. British Journal of Psychiatry, 163, 344–351.Google Scholar
Vázquez-Barquero, J. L., Díez Manrique, J. F., Peña, C., et al (1987) A community mental health survey in Cantabria: a general description of morbidity. Psychological Medicine, 17, 227–241.Google Scholar
Vazquez-Barquero, J. L., Cuesta, M. J., de la Varga, M., et al (1995a) The Cantabria first episode schizophrenia study: a summary of general findings. Acta Psychiatrica Scandinavica, 91, 156–162.Google Scholar
Vazquez-Barquero, J. L., Cuesta, M. J., Quintana, F., et al (1995b) Structural abnormalities of the brain in schizophrenia: Sex differences in the Cantabria First Episode of Schizophrenia Study. Psychological Medicine, 25, 1247–1257.Google Scholar
Vazquez-Barquero, J. L., de la Varga, M., Cuesta, M. J., et al (1996) Sociodemographic and clinical variables as predictors of the diagnostic characteristics of first episodes of schizophrenia. Acta Psychiatrica Scandinavica, in press.Google Scholar
Wing, J., Cooper, J. E. & Sartorius, N. (1974) Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
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