A Dimensional Redefinition of the Schizophrenia Spectrum: Delusional Disorder Versus Schizophrenia Versus Schizoaffective Disorder

Abstract

Introduction Since the early description of paranoia, nosology of delusional disorder has always been controversial. The idea of ??unitary psychosis is old but has now taken on new value from the dimensional continuum model of psychosis. Aims 1. To study the psychopathological dimensions of the schizophrenia spectrum. 2. To explore the relationship between the dimensions obtained and the categorical diagnoses. 3 To compare the different diagnoses of the psychosis from a psychopathological and functional point of view. Material and Methods an observational study with 550 patients was conducted. 373 patients with schizophrenia, 137 patients with delusional disorder, 40 patients with schizoaffective disorder. PANSS was used to assess the psychopathology and GAF for global functioning. Exploratory and confirmatory factor analysis of the PANSS items was performed in order to obtain a dimensional model. The relationship between diagnostic categories and dimensions was subsequently studied with ANOVA tests. Results 5 Factors,-manic, negative symptoms, depression, positive symptoms and cognition-, similar in composition to other models were obtained. The model yielded the 57.27% of the total variance. The dimensional model obtained was able to explain the differences and similarities between the different categories of the schizophrenia spectrum and the validity of the categories was questioned. The value of the model in order to help establish the diagnosis, prognosis and treatment decision-making was postulated.