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; Andrei Szoke; Celso Arango; Antonio Lasalvia; Andrea Tortelli; Pierre-Michel Llorca; Lieuwe de Haan; Eva Velthorst; Julio Bobes; Miguel Bernardo; Julio Sanjuan; 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 P. F. Rutten; Jim van Os; Craig Morgan; Cathryn M. Lewis; Robin M. Murray; Ulrich Reininghaus; Kathryn Hubbard; Stephanie Beards; Simona A. Stilo; Mara Parellada; Pedro Cuadrado; Jose Juan Rodriguez Solano; Angel Carracedo; Enrique Garcia Bernardo; Laura Roldan; Gonzalo Lopez; Bibiana Cabrera; Esther Lorente-Rovira; Paz Garcia-Portilla; Javier Costas; Estela Jimenez-Lopez; Mario Matteis; Marta Rapado; Emiliano Gonzalez; Covadonga Martinez; Emilio Sanchez; Ma Soledad Olmeda; Nathalie Franke; Fabian Termorshuizen; Daniella van Dam; Elsje van der Ven; Elles Messchaart; Marion Leboyer; Franck Schurhoff; Stephane Jamain; Gregoire Baudin; Aziz Ferchiou; Baptiste Pignon; Jean-Romain Richard; Thomas Charpeaud; Anne-Marie Tronche; Flora Frijda; Giovanna Marrazzo; Lucia Sideli; Crocettarachele Sartorio; Fabio Seminerio; Camila Marcelino Loureiro; Rosana Shuhama; Mirella Ruggeri; Sarah Tosato; Chiara Bonetto; Doriana Cristofalo

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
, Andrei Szoke
, Celso Arango
, Antonio Lasalvia
, Andrea Tortelli
, Pierre-Michel Llorca
, Lieuwe de Haan
, Eva Velthorst
, Julio Bobes
, Miguel Bernardo
, Julio Sanjuan

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 P. F. Rutten, Jim van Os, Craig Morgan, Cathryn M. Lewis, Robin M. Murray, Ulrich Reininghaus, Kathryn Hubbard, Stephanie Beards, Simona A. Stilo, Mara Parellada, Pedro Cuadrado, Jose Juan Rodriguez Solano, Angel Carracedo, Enrique Garcia Bernardo, Laura Roldan, Gonzalo Lopez, Bibiana Cabrera, Esther Lorente-Rovira, Paz Garcia-Portilla, Javier Costas, Estela Jimenez-Lopez, Mario Matteis, Marta Rapado, Emiliano Gonzalez, Covadonga Martinez, Emilio Sanchez, Ma Soledad Olmeda, Nathalie Franke, Fabian Termorshuizen, Daniella van Dam, Elsje van der Ven, Elles Messchaart, Marion Leboyer, Franck Schurhoff, Stephane Jamain, Gregoire Baudin, Aziz Ferchiou, Baptiste Pignon, Jean-Romain Richard, Thomas Charpeaud, Anne-Marie Tronche, Flora Frijda, Giovanna Marrazzo, Lucia Sideli, Crocettarachele Sartorio, Fabio Seminerio, Camila Marcelino Loureiro, Rosana Shuhama, Mirella Ruggeri, Sarah Tosato, Chiara Bonetto, Doriana Cristofalo

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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)	1378-1391
Number of pages	14
Journal	Psychological Medicine
Volume	49
Issue number	8
Early online date	2018
DOIs	https://doi.org/10.1017/S0033291718002131
Publication status	Published - Jun 2019

Keywords

Bifactor model
first episode psychosis
symptom dimensions
psychopathology
diagnostic categories

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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., Szoke, A., Arango, C., Lasalvia, A., Tortelli, A., Llorca, P.-M., de Haan, L., Velthorst, E., Bobes, J., Bernardo, M., ... Cristofalo, D. (2019). Transdiagnostic dimensions of psychopathology at first episode psychosis: findings from the multinational EU-GEI study. Psychological Medicine, 49(8), 1378-1391. https://doi.org/10.1017/S0033291718002131

@article{90c34fa2731f46c787054cedf72ba2c5,

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.",

keywords = "Bifactor model, first episode psychosis, symptom dimensions, psychopathology, diagnostic categories",

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 Andrei Szoke 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 Sanjuan and \{Luis Santos\}, Jose 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 P. F.\} and \{van Os\}, Jim and Craig Morgan and Lewis, \{Cathryn M.\} and Murray, \{Robin M.\} and Ulrich Reininghaus and Kathryn Hubbard and Stephanie Beards and Stilo, \{Simona A.\} and Mara Parellada and Pedro Cuadrado and \{Rodriguez Solano\}, \{Jose Juan\} and Angel Carracedo and \{Garcia Bernardo\}, Enrique and Laura Roldan and Gonzalo Lopez and Bibiana Cabrera and Esther Lorente-Rovira and Paz Garcia-Portilla and Javier Costas and Estela Jimenez-Lopez and Mario Matteis and Marta Rapado and Emiliano Gonzalez and Covadonga Martinez and Emilio Sanchez and Olmeda, \{Ma Soledad\} and Nathalie Franke and Fabian Termorshuizen and \{van Dam\}, Daniella and \{van der Ven\}, Elsje and Elles Messchaart and Marion Leboyer and Franck Schurhoff and Stephane Jamain and Gregoire Baudin and Aziz Ferchiou and Baptiste Pignon and Jean-Romain Richard and Thomas Charpeaud and Anne-Marie Tronche and Flora Frijda and Giovanna Marrazzo and Lucia Sideli and Crocettarachele Sartorio and Fabio Seminerio and Loureiro, \{Camila Marcelino\} and Rosana Shuhama and Mirella Ruggeri and Sarah Tosato and Chiara Bonetto and Doriana Cristofalo",

note = "Publisher Copyright: {\textcopyright} Cambridge University Press 2018.",

year = "2019",

month = jun,

doi = "10.1017/S0033291718002131",

language = "English",

volume = "49",

pages = "1378--1391",

journal = "Psychological Medicine",

issn = "0033-2917",

publisher = "Cambridge University Press",

number = "8",

}

Quattrone, D, Di Forti, M, Gayer-Anderson, C, Ferraro, L, Jongsma, HE, Tripoli, G, La Cascia, C, La Barbera, D, Tarricone, I, Berardi, D, Szoke, A, Arango, C, Lasalvia, A, Tortelli, A, Llorca, P-M, de Haan, L, Velthorst, E, Bobes, J, Bernardo, M, Sanjuan, J, Luis Santos, J, Arrojo, M, Del-Ben, CM, Menezes, PR, Selten, J-P, Jones, PB, Kirkbride, JB, Richards, AL, O'Donovan, MC, Sham, PC, Vassos, E, Rutten, BPF, van Os, J, Morgan, C, Lewis, CM, Murray, RM, Reininghaus, U, Hubbard, K, Beards, S, Stilo, SA, Parellada, M, Cuadrado, P, Rodriguez Solano, JJ, Carracedo, A, Garcia Bernardo, E, Roldan, L, Lopez, G, Cabrera, B, Lorente-Rovira, E, Garcia-Portilla, P, Costas, J, Jimenez-Lopez, E, Matteis, M, Rapado, M, Gonzalez, E, Martinez, C, Sanchez, E, Olmeda, MS, Franke, N, Termorshuizen, F, van Dam, D, van der Ven, E, Messchaart, E, Leboyer, M, Schurhoff, F, Jamain, S, Baudin, G, Ferchiou, A, Pignon, B, Richard, J-R, Charpeaud, T, Tronche, A-M, Frijda, F, Marrazzo, G, Sideli, L, Sartorio, C, Seminerio, F, Loureiro, CM, Shuhama, R, Ruggeri, M, Tosato, S, Bonetto, C & Cristofalo, D 2019, 'Transdiagnostic dimensions of psychopathology at first episode psychosis: findings from the multinational EU-GEI study', Psychological Medicine, vol. 49, no. 8, pp. 1378-1391. 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 - Szoke, 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 - Sanjuan, Julio

AU - Luis Santos, Jose

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 P. F.

AU - van Os, Jim

AU - Morgan, Craig

AU - Lewis, Cathryn M.

AU - Murray, Robin M.

AU - Reininghaus, Ulrich

AU - Hubbard, Kathryn

AU - Beards, Stephanie

AU - Stilo, Simona A.

AU - Parellada, Mara

AU - Cuadrado, Pedro

AU - Rodriguez Solano, Jose Juan

AU - Carracedo, Angel

AU - Garcia Bernardo, Enrique

AU - Roldan, Laura

AU - Lopez, Gonzalo

AU - Cabrera, Bibiana

AU - Lorente-Rovira, Esther

AU - Garcia-Portilla, Paz

AU - Costas, Javier

AU - Jimenez-Lopez, Estela

AU - Matteis, Mario

AU - Rapado, Marta

AU - Gonzalez, Emiliano

AU - Martinez, Covadonga

AU - Sanchez, Emilio

AU - Olmeda, Ma Soledad

AU - Franke, Nathalie

AU - Termorshuizen, Fabian

AU - van Dam, Daniella

AU - van der Ven, Elsje

AU - Messchaart, Elles

AU - Leboyer, Marion

AU - Schurhoff, Franck

AU - Jamain, Stephane

AU - Baudin, Gregoire

AU - Ferchiou, Aziz

AU - Pignon, Baptiste

AU - Richard, Jean-Romain

AU - Charpeaud, Thomas

AU - Tronche, Anne-Marie

AU - Frijda, Flora

AU - Marrazzo, Giovanna

AU - Sideli, Lucia

AU - Sartorio, Crocettarachele

AU - Seminerio, Fabio

AU - Loureiro, Camila Marcelino

AU - Shuhama, Rosana

AU - Ruggeri, Mirella

AU - Tosato, Sarah

AU - Bonetto, Chiara

AU - Cristofalo, Doriana

PY - 2019/6

Y1 - 2019/6

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.

KW - Bifactor model

KW - first episode psychosis

KW - symptom dimensions

KW - psychopathology

KW - diagnostic categories

UR - https://www.scopus.com/pages/publications/85062657171

U2 - 10.1017/S0033291718002131

DO - 10.1017/S0033291718002131

M3 - Article

C2 - 30282569

SN - 0033-2917

VL - 49

SP - 1378

EP - 1391

JO - Psychological Medicine

JF - Psychological Medicine

IS - 8

ER -

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

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