Transdiagnostic dimensions of psychopathology at first episode psychosis: findings from the multinational EU-GEI study

Diego Quattrone; Marta Di Forti; Charlotte Gayer-Anderson; Laura Ferraro; Hannah E Jongsma; Giada Tripoli; Caterina La Cascia; Daniele La Barbera; Ilaria Tarricone; Domenico Berardi; EU-GEI WP2 Group; Andrei Szöke; Celso Arango; Antonio Lasalvia; Andrea Tortelli; Pierre-Michel Llorca; Lieuwe de Haan; Eva Velthorst; Julio Bobes; Miguel Bernardo; Julio Sanjuán; Jose Luis Santos; Manuel Arrojo; Cristina Marta Del-Ben; Paulo Rossi Menezes; Jean-Paul Selten; Peter B Jones; James B Kirkbride; Alexander L Richards; Michael C O'Donovan; Pak C Sham; Evangelos Vassos; Bart Pf Rutten; Jim van Os; Craig Morgan; Cathryn M Lewis; Robin M Murray; Ulrich Reininghaus

doi:10.1017/S0033291718002131

Transdiagnostic dimensions of psychopathology at first episode psychosis: findings from the multinational EU-GEI study

Diego Quattrone, Marta Di Forti, Charlotte Gayer-Anderson, Laura Ferraro, Hannah E Jongsma, Giada Tripoli, Caterina La Cascia, Daniele La Barbera, Ilaria Tarricone, Domenico Berardi, EU-GEI WP2 Group, Andrei Szöke, Celso Arango, Antonio Lasalvia, Andrea Tortelli, Pierre-Michel Llorca, Lieuwe de Haan, Eva Velthorst, Julio Bobes, Miguel BernardoJulio Sanjuán, Jose Luis Santos, Manuel Arrojo, Cristina Marta Del-Ben, Paulo Rossi Menezes, Jean-Paul Selten, Peter B Jones, James B Kirkbride, Alexander L Richards, Michael C O'Donovan, Pak C Sham, Evangelos Vassos, Bart Pf Rutten, Jim van Os, Craig Morgan, Cathryn M Lewis, Robin M Murray, Ulrich Reininghaus

Research output: Contribution to journal › Article › peer-review

72 Citations (Scopus)

Abstract

BACKGROUND: The value of the nosological distinction between non-affective and affective psychosis has frequently been challenged. We aimed to investigate the transdiagnostic dimensional structure and associated characteristics of psychopathology at First Episode Psychosis (FEP). Regardless of diagnostic categories, we expected that positive symptoms occurred more frequently in ethnic minority groups and in more densely populated environments, and that negative symptoms were associated with indices of neurodevelopmental impairment.

METHOD: This study included 2182 FEP individuals recruited across six countries, as part of the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study. Symptom ratings were analysed using multidimensional item response modelling in Mplus to estimate five theory-based models of psychosis. We used multiple regression models to examine demographic and context factors associated with symptom dimensions.

RESULTS: A bifactor model, composed of one general factor and five specific dimensions of positive, negative, disorganization, manic and depressive symptoms, best-represented associations among ratings of psychotic symptoms. Positive symptoms were more common in ethnic minority groups. Urbanicity was associated with a higher score on the general factor. Men presented with more negative and less depressive symptoms than women. Early age-at-first-contact with psychiatric services was associated with higher scores on negative, disorganized, and manic symptom dimensions.

CONCLUSIONS: Our results suggest that the bifactor model of psychopathology holds across diagnostic categories of non-affective and affective psychosis at FEP, and demographic and context determinants map onto general and specific symptom dimensions. These findings have implications for tailoring symptom-specific treatments and inform research into the mood-psychosis spectrum.

Original language	English
Pages (from-to)	1-14
Number of pages	14
Journal	Psychological Medicine
Early online date	4 Oct 2018
DOIs	https://doi.org/10.1017/S0033291718002131
Publication status	E-pub ahead of print - 4 Oct 2018

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10.1017/S0033291718002131Licence: CC BY

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Quattrone, D., Di Forti, M., Gayer-Anderson, C., Ferraro, L., Jongsma, H. E., Tripoli, G., La Cascia, C., La Barbera, D., Tarricone, I., Berardi, D., EU-GEI WP2 Group, Szöke, A., Arango, C., Lasalvia, A., Tortelli, A., Llorca, P.-M., de Haan, L., Velthorst, E., Bobes, J., ... Reininghaus, U. (2018). Transdiagnostic dimensions of psychopathology at first episode psychosis: findings from the multinational EU-GEI study. Psychological Medicine, 1-14. Advance online publication. https://doi.org/10.1017/S0033291718002131

@article{560cb26481cd42eaafe3c0dd22f473e2,

title = "Transdiagnostic dimensions of psychopathology at first episode psychosis: findings from the multinational EU-GEI study",

abstract = "BACKGROUND: The value of the nosological distinction between non-affective and affective psychosis has frequently been challenged. We aimed to investigate the transdiagnostic dimensional structure and associated characteristics of psychopathology at First Episode Psychosis (FEP). Regardless of diagnostic categories, we expected that positive symptoms occurred more frequently in ethnic minority groups and in more densely populated environments, and that negative symptoms were associated with indices of neurodevelopmental impairment.METHOD: This study included 2182 FEP individuals recruited across six countries, as part of the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study. Symptom ratings were analysed using multidimensional item response modelling in Mplus to estimate five theory-based models of psychosis. We used multiple regression models to examine demographic and context factors associated with symptom dimensions.RESULTS: A bifactor model, composed of one general factor and five specific dimensions of positive, negative, disorganization, manic and depressive symptoms, best-represented associations among ratings of psychotic symptoms. Positive symptoms were more common in ethnic minority groups. Urbanicity was associated with a higher score on the general factor. Men presented with more negative and less depressive symptoms than women. Early age-at-first-contact with psychiatric services was associated with higher scores on negative, disorganized, and manic symptom dimensions.CONCLUSIONS: Our results suggest that the bifactor model of psychopathology holds across diagnostic categories of non-affective and affective psychosis at FEP, and demographic and context determinants map onto general and specific symptom dimensions. These findings have implications for tailoring symptom-specific treatments and inform research into the mood-psychosis spectrum.",

author = "Diego Quattrone and {Di Forti}, Marta and Charlotte Gayer-Anderson and Laura Ferraro and Jongsma, {Hannah E} and Giada Tripoli and {La Cascia}, Caterina and {La Barbera}, Daniele and Ilaria Tarricone and Domenico Berardi and {EU-GEI WP2 Group} and Andrei Sz{\"o}ke and Celso Arango and Antonio Lasalvia and Andrea Tortelli and Pierre-Michel Llorca and {de Haan}, Lieuwe and Eva Velthorst and Julio Bobes and Miguel Bernardo and Julio Sanju{\'a}n and Santos, {Jose Luis} and Manuel Arrojo and Del-Ben, {Cristina Marta} and Menezes, {Paulo Rossi} and Jean-Paul Selten and Jones, {Peter B} and Kirkbride, {James B} and Richards, {Alexander L} and O'Donovan, {Michael C} and Sham, {Pak C} and Evangelos Vassos and Rutten, {Bart Pf} and {van Os}, Jim and Craig Morgan and Lewis, {Cathryn M} and Murray, {Robin M} and Ulrich Reininghaus",

year = "2018",

month = oct,

day = "4",

doi = "10.1017/S0033291718002131",

language = "English",

pages = "1--14",

journal = "Psychological Medicine",

issn = "0033-2917",

publisher = "Cambridge University Press",

}

Quattrone, D , Di Forti, M , Gayer-Anderson, C, Ferraro, L, Jongsma, HE, Tripoli, G, La Cascia, C, La Barbera, D, Tarricone, I, Berardi, D, EU-GEI WP2 Group, Szöke, A, Arango, C, Lasalvia, A, Tortelli, A, Llorca, P-M, de Haan, L, Velthorst, E, Bobes, J, Bernardo, M, Sanjuán, J, Santos, JL, Arrojo, M, Del-Ben, CM, Menezes, PR, Selten, J-P, Jones, PB, Kirkbride, JB, Richards, AL, O'Donovan, MC, Sham, PC, Vassos, E, Rutten, BP, van Os, J , Morgan, C , Lewis, CM , Murray, RM & Reininghaus, U 2018, 'Transdiagnostic dimensions of psychopathology at first episode psychosis: findings from the multinational EU-GEI study', Psychological Medicine, pp. 1-14. https://doi.org/10.1017/S0033291718002131

TY - JOUR

T1 - Transdiagnostic dimensions of psychopathology at first episode psychosis

T2 - findings from the multinational EU-GEI study

AU - Quattrone, Diego

AU - Di Forti, Marta

AU - Gayer-Anderson, Charlotte

AU - Ferraro, Laura

AU - Jongsma, Hannah E

AU - Tripoli, Giada

AU - La Cascia, Caterina

AU - La Barbera, Daniele

AU - Tarricone, Ilaria

AU - Berardi, Domenico

AU - EU-GEI WP2 Group

AU - Szöke, Andrei

AU - Arango, Celso

AU - Lasalvia, Antonio

AU - Tortelli, Andrea

AU - Llorca, Pierre-Michel

AU - de Haan, Lieuwe

AU - Velthorst, Eva

AU - Bobes, Julio

AU - Bernardo, Miguel

AU - Sanjuán, Julio

AU - Santos, Jose Luis

AU - Arrojo, Manuel

AU - Del-Ben, Cristina Marta

AU - Menezes, Paulo Rossi

AU - Selten, Jean-Paul

AU - Jones, Peter B

AU - Kirkbride, James B

AU - Richards, Alexander L

AU - O'Donovan, Michael C

AU - Sham, Pak C

AU - Vassos, Evangelos

AU - Rutten, Bart Pf

AU - van Os, Jim

AU - Morgan, Craig

AU - Lewis, Cathryn M

AU - Murray, Robin M

AU - Reininghaus, Ulrich

PY - 2018/10/4

Y1 - 2018/10/4

N2 - BACKGROUND: The value of the nosological distinction between non-affective and affective psychosis has frequently been challenged. We aimed to investigate the transdiagnostic dimensional structure and associated characteristics of psychopathology at First Episode Psychosis (FEP). Regardless of diagnostic categories, we expected that positive symptoms occurred more frequently in ethnic minority groups and in more densely populated environments, and that negative symptoms were associated with indices of neurodevelopmental impairment.METHOD: This study included 2182 FEP individuals recruited across six countries, as part of the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study. Symptom ratings were analysed using multidimensional item response modelling in Mplus to estimate five theory-based models of psychosis. We used multiple regression models to examine demographic and context factors associated with symptom dimensions.RESULTS: A bifactor model, composed of one general factor and five specific dimensions of positive, negative, disorganization, manic and depressive symptoms, best-represented associations among ratings of psychotic symptoms. Positive symptoms were more common in ethnic minority groups. Urbanicity was associated with a higher score on the general factor. Men presented with more negative and less depressive symptoms than women. Early age-at-first-contact with psychiatric services was associated with higher scores on negative, disorganized, and manic symptom dimensions.CONCLUSIONS: Our results suggest that the bifactor model of psychopathology holds across diagnostic categories of non-affective and affective psychosis at FEP, and demographic and context determinants map onto general and specific symptom dimensions. These findings have implications for tailoring symptom-specific treatments and inform research into the mood-psychosis spectrum.

AB - BACKGROUND: The value of the nosological distinction between non-affective and affective psychosis has frequently been challenged. We aimed to investigate the transdiagnostic dimensional structure and associated characteristics of psychopathology at First Episode Psychosis (FEP). Regardless of diagnostic categories, we expected that positive symptoms occurred more frequently in ethnic minority groups and in more densely populated environments, and that negative symptoms were associated with indices of neurodevelopmental impairment.METHOD: This study included 2182 FEP individuals recruited across six countries, as part of the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study. Symptom ratings were analysed using multidimensional item response modelling in Mplus to estimate five theory-based models of psychosis. We used multiple regression models to examine demographic and context factors associated with symptom dimensions.RESULTS: A bifactor model, composed of one general factor and five specific dimensions of positive, negative, disorganization, manic and depressive symptoms, best-represented associations among ratings of psychotic symptoms. Positive symptoms were more common in ethnic minority groups. Urbanicity was associated with a higher score on the general factor. Men presented with more negative and less depressive symptoms than women. Early age-at-first-contact with psychiatric services was associated with higher scores on negative, disorganized, and manic symptom dimensions.CONCLUSIONS: Our results suggest that the bifactor model of psychopathology holds across diagnostic categories of non-affective and affective psychosis at FEP, and demographic and context determinants map onto general and specific symptom dimensions. These findings have implications for tailoring symptom-specific treatments and inform research into the mood-psychosis spectrum.

U2 - 10.1017/S0033291718002131

DO - 10.1017/S0033291718002131

M3 - Article

C2 - 30282569

SN - 0033-2917

SP - 1

EP - 14

JO - Psychological Medicine

JF - Psychological Medicine

ER -

Transdiagnostic dimensions of psychopathology at first episode psychosis: findings from the multinational EU-GEI study

Abstract

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