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

Ulrich Reininghaus, Jan Rasmus Boehnke, Georgina M. Hosang, Anne E. Farmer, Tom Burns, Peter McGuffin, Richard P. Bentall

    Research output: Contribution to journalArticle

    39 Citations (Scopus)

    Abstract

    Background

    In recent years, the Kraepelinian dichotomy has been challenged in light of evidence on shared genetic and environmental factors for schizophrenia and bipolar disorder, but empirical efforts to identify a transdiagnostic phenotype of psychosis remain remarkably limited.

    Aims

    To investigate whether schizophrenia spectrum and bipolar disorder lie on a transdiagnostic spectrum with overlapping non-affective and affective psychotic symptoms.

    Method

    Multidimensional item-response modelling was conducted on symptom ratings of the OPerational CRITeria (OPCRIT) system in 1168 patients with schizophrenia spectrum and bipolar disorder.

    Results

    A bifactor model with one general, transdiagnostic psychosis dimension underlying affective and non-affective psychotic symptoms and five specific dimensions of positive, negative, disorganised, manic and depressive symptoms provided the best model fit and diagnostic utility for categorical classification.

    Conclusions

    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.
    Original languageEnglish
    Pages (from-to)107-113
    Number of pages7
    JournalBritish Journal of Psychiatry
    Volume209
    Issue number2
    DOIs
    Publication statusPublished - 1 Aug 2016

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