Evaluation of the validity and utility of a transdiagnostic psychosis dimension encompassing schizophrenia and bipolar disorder

Reininghaus, Ulrich; Böhnke, Jan R.; Hosang, Georgina M.; Farmer, Anne; Burns, Tom; McGuffin, Peter; Bentall, Richard P.

doi:10.1192/bjp.bp.115.167882

Cited by 80 publications

(110 citation statements)

References 38 publications

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“…It will be of interest to apply this hierarchical finite mixture model technique to subtypes of CT in whom heterogeneity may be linked to group. Conceivably, it may one day be possible to develop a transdiagnostic TD phenotype 164 that can be used to enhance the identification of nonpenetrant SMI gene carriers.…”

Section: Discussionmentioning

confidence: 99%

Thought Disorder in Schizophrenia and Bipolar Disorder Probands, Their Relatives, and Nonpsychiatric Controls

Morgan

Coleman

Ülgen

et al. 2017

Schizophrenia Bulletin

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Thought disorder (TD) has long been associated with schizophrenia (SZ) and is now widely recognized as a symptom of mania and other psychotic disorders as well. Previous studies have suggested that the TD found in the clinically unaffected relatives of SZ, schizoaffective and bipolar probands is qualitatively similar to that found in the probands themselves. Here, we examine which quantitative measures of TD optimize the distinction between patients with diagnoses of SZ and bipolar disorder with psychotic features (BP) from nonpsychiatric controls (NC) and from each other. In addition, we investigate whether these same TD measures also distinguish their respective clinically unaffected relatives (RelSZ, RelBP) from controls as well as from each other. We find that deviant verbalizations are significantly associated with SZ and are co-familial in clinically unaffected RelSZ, but are dissociated from, and are not co-familial for, BP disorder. In contrast, combinatory thinking was nonspecifically associated with psychosis, but did not aggregate in either group of relatives. These results provide further support for the usefulness of TD for identifying potential non-penetrant carriers of SZ-risk genes, in turn enhancing the power of genetic analyses. These findings also suggest that further refinement of the TD phenotype may be needed in order to be suitable for use in genetic studies of bipolar disorder.

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Section: Discussionmentioning

confidence: 99%

Thought Disorder in Schizophrenia and Bipolar Disorder Probands, Their Relatives, and Nonpsychiatric Controls

Morgan

Coleman

Ülgen

et al. 2017

Schizophrenia Bulletin

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“…The ecological interventionist causal model approach thus targets the putative psychological mechanism in daily life to test whether an ecological momentary intervention can (i) modify this mechanism and (ii) produce changes in the mechanism that lead to changes in intended psychosis outcomes (ie, whether the effect of an ecological momentary intervention on psychotic symptoms is mediated via pathways through this mechanism) 50 (see figure 1). Such interventions could be scalable given the ubiquity of mobile devices, and thus corresponds to calls for research that identifies mechanisms in clinical trials, 51 provides the best evidence to relevant clinical problems of everyday practice, 52 which is generalizable to both social contexts in the real world 13,[53][54][55] and heterogeneous patient populations across the transdiagnostic psychosis disorder spectrum, 56,57 and informs the service user as well as clinician perspective. [58][59][60][61] The benefits of such an ecological interventionist causal model approach are at least 2-fold.…”

Section: Targeting Putative Psychological Mechanisms In Daily Life: Amentioning

confidence: 99%

Ecological Interventionist Causal Models in Psychosis: Targeting Psychological Mechanisms in Daily Life

Reininghaus

Depp

Myin-Germeys

2015

SCHBUL

Self Cite

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Integrated models of psychotic disorders have posited a number of putative psychological mechanisms that may contribute to the development of psychotic symptoms, but it is only recently that a modest amount of experience sampling research has provided evidence on their role in daily life, outside the research laboratory. A number of methodological challenges remain in evaluating specificity of potential causal links between a given psychological mechanism and psychosis outcomes in a systematic fashion, capitalizing on longitudinal data to investigate temporal ordering. In this article, we argue for testing ecological interventionist causal models that draw on real world and real-time delivered, ecological momentary interventions for generating evidence on several causal criteria (association, time order, and direction/sole plausibility) under real-world conditions, while maximizing generalizability to social contexts and experiences in heterogeneous populations. Specifically, this approach tests whether ecological momentary interventions can (1) modify a putative mechanism and (2) produce changes in the mechanism that lead to sustainable changes in intended psychosis outcomes in individuals' daily lives. Future research using this approach will provide translational evidence on the active ingredients of mobile health and in-person interventions that promote sustained effectiveness of ecological momentary interventions and, thereby, contribute to ongoing efforts that seek to enhance effectiveness of psychological interventions under real-world conditions.

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“…Furthermore, there is a rising awareness of important communalities between schizophrenia and other conditions like bipolar disorder [48] . Both findings oppose the idea of there being one specific core disturbance and suggest giving up the idea of schizophrenia as a distinct nosological category in favor of a transdiagnostic approach [49][50][51] .…”

Section: Demarcation From Other Mental Illnessesmentioning

confidence: 60%

“…Against the background of currently debated changes to the established nosological framework -especially the waning tradition of core disturbance [6] , the trend towards denosologisation [4,62,63] and transdiagnostic thinking [4,[49][50][51] -it remains to be seen how schizophrenia, the self, and their entrenched conceptual alliance will fare.…”

Section: The Conceptual Alliance Of Schizophrenia and Self Reconsideredmentioning

confidence: 99%

Schizophrenia, Self, and Person: Eugen Bleuler and Arthur Kronfeld on a Conceptual Alliance

Maatz

Hoff

2017

Psychopathology

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The conceptual history of schizophrenia is marked by considerable dissent about its nosological status, and the question of whether it represents a distinct disease entity remains hotly debated. Another recurring feature in the conceptual history of schizophrenia is the reference to concepts of self and person. This paper brings in connection these two debates by interrogating the nosological function of “self” and “person” by means of a fictitious dialogue between Eugen Bleuler, the inventor of schizophrenia, and his contemporary Arthur Kronfeld. Introducing their respective accounts of schizophrenia with a special focus on how concepts of self and person figure therein, our analysis suggests that these concepts are primarily employed in an attempt to guarantee the nosological unity of schizophrenia: mediated by the concept of a core disturbance, alterations of the self or the person thus become the essential core of schizophrenia. Yet, rather than providing an easy solution to the nosological problem of the unity of schizophrenia, the concepts of self and person and their assumed disturbances are themselves fraught with debates about unity. We discuss these conceptual challenges in light of present-day nosological debates and the currently abounding research on the self.

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Evaluation of the validity and utility of a transdiagnostic psychosis dimension encompassing schizophrenia and bipolar disorder

Abstract: Our findings provide support for including dimensional approaches into classification systems and a directly measurable clinical phenotype for cross-disorder investigations into shared genetic and environmental factors of psychosis.

Cited by 80 publications

References 38 publications

Thought Disorder in Schizophrenia and Bipolar Disorder Probands, Their Relatives, and Nonpsychiatric Controls

Thought Disorder in Schizophrenia and Bipolar Disorder Probands, Their Relatives, and Nonpsychiatric Controls

Ecological Interventionist Causal Models in Psychosis: Targeting Psychological Mechanisms in Daily Life

Schizophrenia, Self, and Person: Eugen Bleuler and Arthur Kronfeld on a Conceptual Alliance

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