Universität zu Köln

Jimeno, Natalia ORCID: 0000-0002-9618-3424, Gomez-Pilar, Javier, Poza, Jesus, Hornero, Roberto, Vogeley, Kai, Meisenzahl, Eva, Haidl, Theresa, Rosen, Marlene, Klosterkoetter, Joachim and Schultze-Lutter, Frauke (2020). Main Symptomatic Treatment Targets in Suspected and Early Psychosis: New Insights From Network Analysis. Schizophr. Bull., 46 (4). S. 884 - 896. OXFORD: OXFORD UNIV PRESS. ISSN 1745-1701

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Abstract

The early detection and intervention in psychoses prior to their first episode are presently based on the symptomatic ultra-high-risk and the basic symptom criteria. Current models of symptom development assume that basic symptoms develop first, followed by attenuated and, finally, frank psychotic symptoms, though interrelations of these symptoms are yet unknown. Therefore, we studied for the first time their interrelations using a network approach in 460 patients of an early detection service (mean age = 26.3 y, SD = 6.4; 65% male; n = 203 clinical high-risk [CHR], n = 153 first-episode psychosis, and n = 104 depression). Basic, attenuated, and frank psychotic symptoms were assessed using the Schizophrenia Proneness Instrument, Adult version (SPI-A), the Structured Interview for Psychosis-Risk Syndromes (SIPS), and the Positive And Negative Syndrome Scale (PANSS). Using the R package qgraph, network analysis of the altogether 86 symptoms revealed a single dense network of highly interrelated symptoms with 5 discernible symptom subgroups. Disorganized communication was the most central symptom, followed by delusions and hallucinations. In line with current models of symptom development, the network was distinguished by symptom severity running from SPI-A via SIPS to PANSS assessments. This suggests that positive symptoms developed from cognitive and perceptual disturbances included basic symptom criteria. Possibly conveying important insight for clinical practice, central symptoms, and symptoms bridging the association between symptom subgroups may be regarded as the main treatment targets, in order to prevent symptomatology from spreading or increasing across the whole network.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Jimeno, Natalia UNSPECIFIED orcid.org/0000-0002-9618-3424 UNSPECIFIED Gomez-Pilar, Javier UNSPECIFIED UNSPECIFIED UNSPECIFIED Poza, Jesus UNSPECIFIED UNSPECIFIED UNSPECIFIED Hornero, Roberto UNSPECIFIED UNSPECIFIED UNSPECIFIED Vogeley, Kai UNSPECIFIED UNSPECIFIED UNSPECIFIED Meisenzahl, Eva UNSPECIFIED UNSPECIFIED UNSPECIFIED Haidl, Theresa UNSPECIFIED UNSPECIFIED UNSPECIFIED Rosen, Marlene UNSPECIFIED UNSPECIFIED UNSPECIFIED Klosterkoetter, Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED Schultze-Lutter, Frauke UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-327128
DOI:	10.1093/schbul/sbz140
Journal or Publication Title:	Schizophr. Bull.
Volume:	46
Number:	4
Page Range:	S. 884 - 896
Date:	2020
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1745-1701
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CLINICAL HIGH-RISK; NEGATIVE-SYNDROME-SCALE; PRODROMAL SYMPTOMS; INTERRATER RELIABILITY; POSITIVE SYMPTOMS; BASIC SYMPTOMS; 5-FACTOR MODEL; YOUNG-PEOPLE; SCHIZOPHRENIA; PREDICTION Multiple languages Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/32712