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Distribution of symptom dimensions across Kraepelinian divisions

  • Dimitris G. Dikeos (a1), Harvey Wickham (a2), Colm McDonald (a3), Muriel Walshe (a2), Thordur Sigmundsson (a4), Elvira Bramon (a2), Anton Grech (a5), Timothea Toulopoulou (a2), Robin Murray (a2) and Pak C. Sham (a6)...

Abstract

Background

Dimensional structures are established for many psychiatric diagnoses, but dimensions have not been compared between diagnostic groups.

Aims

To examine the structure of dimensions in psychosis, to analyse their correlations with disease characteristics and to assess the relative contribution of dimensions v. diagnosis in explaining these characteristics.

Method

Factor analysis of the OPCRIT items of 191 Maudsley Family Study patients with schizophrenia, mood disorders with psychosis, schizoaffective disorder, and other psychotic illnesses, followed by regression of disease characteristics from factor scores and diagnosis.

Results

Five factors were identified (mania, reality distortion, depression, disorganisation, negative); all were more variable in schizophrenia than in affective psychosis. Mania was the best discriminator between schizophrenia and affective psychosis; the negative factor was strongly correlated with poor premorbid functioning, insidious onset and worse course. Dimensions explained more of the disease characteristics than did diagnosis, but the explanatory power of the latter was also high.

Conclusions

Kraepelinian diagnostic categories suffice for understanding illness characteristics, but the use of dimensions adds substantial information.

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Copyright

Corresponding author

Dr Dimitris G. Dikeos, Institute of Psychiatry, SGDP Building, De Crespigny Park, Denmark Hill, London SE5 8AF, UK. Tel: +44(0)20 7848 0854; email d.dikeos@iop.kcl.ac.uk

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Distribution of symptom dimensions across Kraepelinian divisions

  • Dimitris G. Dikeos (a1), Harvey Wickham (a2), Colm McDonald (a3), Muriel Walshe (a2), Thordur Sigmundsson (a4), Elvira Bramon (a2), Anton Grech (a5), Timothea Toulopoulou (a2), Robin Murray (a2) and Pak C. Sham (a6)...

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