What Can Be Learned from Dimensional Perspectives on Psychiatry?

Walther, Sebastian; Morrens, Manuel

doi:10.1159/000508762

Cited by 3 publications

(1 citation statement)

References 13 publications

(12 reference statements)

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“…Still, they are of increasing interest (4,5), due to the strong associations with low remission rates, reduced quality of life and impaired functioning (6, 7). Recent developments in psychiatry have moved toward a dimensional rather than a categorical understanding of clinical symptoms and diagnoses (8,9). Negative symptoms are thus not pathognomonic to any specific psychiatric or neurological disorder -despite their historical link to schizophrenia -and are regularly present in other psychiatric disorders, such as bipolar disorder (BD) (10).…”

Section: Introductionmentioning

confidence: 99%

A transdiagnostic approach to negative symptoms: exploring factor structure and negative symptoms in bipolar disorders

et al. 2023

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BackgroundNegative symptoms are increasingly recognized as transdiagnostic phenomena, linked to reduced quality of life and functioning, and often caused or worsened by amendable external factors such as depression, social deprivation, side-effects of antipsychotics or substance use. The structure of negative symptoms fits into two dimensions: diminished expression and apathy. These may differ in association with external factors that influence their severity and may thus require different treatment approaches. The dimensions are comprehensively established in non-affective psychotic disorders but are understudied in bipolar disorders.MethodsWe conducted exploratory and confirmatory factor analyses in a sample of 584 individuals with bipolar disorder to assess the latent factor structure of negative symptoms as measured by the Positive and Negative Syndrome Scale (PANSS), and performed correlational analyses and multiple hierarchical regression analyses to investigate links between the two dimensions of negative symptoms and clinical and sociodemographic correlates.ResultsThe latent factor structure of negative symptoms fits into two dimensions, i.e., diminished expression and apathy. A diagnosis of bipolar type I or a history of psychotic episodes predicted more severe levels of diminished expression. Depressive symptoms were associated with more severe negative symptoms across dimensions, yet 26.3% of euthymic individuals still displayed at least one mild or more severe negative symptom (PANSS score ≥ 3).DiscussionThe two-dimensional structure of negative symptoms seen in non-affective psychotic disorders reproduces in bipolar disorders indicating similarities in their phenomenology. Diminished expression was associated with a history of psychotic episodes and a diagnosis of BD-I, which may infer closer connections to psychosis liability. We found significantly less severe negative symptoms in euthymic than depressed participants. Nevertheless, more than a quarter of the euthymic individuals had at least one mild negative symptom, demonstrating some degree of persistence beyond depressed states.

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Section: Introductionmentioning

confidence: 99%

A transdiagnostic approach to negative symptoms: exploring factor structure and negative symptoms in bipolar disorders

et al. 2023

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Brain Structural Network Connectivity of Formal Thought Disorder Dimensions in Affective and Psychotic Disorders

Stein

Gruber

Mauritz

et al. 2024

Biological Psychiatry

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Dimensions of Formal Thought Disorder and Their Relation to Gray- and White Matter Brain Structure in Affective and Psychotic Disorders

Stein

Buckenmayer

Meller

et al. 2022

Schizophrenia Bulletin

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Factorial dimensions and neurobiological underpinnings of formal thought disorders (FTD) have been extensively investigated in schizophrenia spectrum disorders (SSD). However, FTD are also highly prevalent in other disorders. Still, there is a lack of knowledge about transdiagnostic, structural brain correlates of FTD. In N = 1071 patients suffering from DSM-IV major depressive disorder, bipolar disorder, or SSD, we calculated a psychopathological factor model of FTD based on the SAPS and SANS scales. We tested the association of FTD dimensions with 3 T MRI measured gray matter volume (GMV) and white matter fractional anisotropy (FA) using regression and interaction models in SPM12. We performed post hoc confirmatory analyses in diagnostically equally distributed, age- and sex-matched sub-samples to test whether results were driven by diagnostic categories. Cross-validation (explorative and confirmatory) factor analyses revealed three psychopathological FTD factors: disorganization, emptiness, and incoherence. Disorganization was negatively correlated with a GMV cluster comprising parts of the middle occipital and angular gyri and positively with FA in the right posterior cingulum bundle and inferior longitudinal fascicle. Emptiness was negatively associated with left hippocampus and thalamus GMV. Incoherence was negatively associated with FA in bilateral anterior thalamic radiation, and positively with the hippocampal part of the right cingulum bundle. None of the gray or white matter associations interacted with diagnosis. Our results provide a refined mapping of cross-disorder FTD phenotype dimensions. For the first time, we demonstrated that their neuroanatomical signatures are associated with language-related gray and white matter structures independent of diagnosis.

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What Can Be Learned from Dimensional Perspectives on Psychiatry?

Cited by 3 publications

References 13 publications

A transdiagnostic approach to negative symptoms: exploring factor structure and negative symptoms in bipolar disorders

A transdiagnostic approach to negative symptoms: exploring factor structure and negative symptoms in bipolar disorders

Brain Structural Network Connectivity of Formal Thought Disorder Dimensions in Affective and Psychotic Disorders

Dimensions of Formal Thought Disorder and Their Relation to Gray- and White Matter Brain Structure in Affective and Psychotic Disorders

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