Symptom dimensions and their association with outcome and treatment setting in long-term schizophrenia. Results of the DSP project

Abstract

National representative samples of 1571 schizophrenia patients discharged from mental hospitals in Finland in 1990 and 1994 were interviewed 3 years after discharge. The symptom items assessed by the PANSS were factorized and orthogonal rotations were performed. Five factor dimensions, negative, positive, depressive, hostile and disorganization dimension, were obtained and correlated with data of patients' socio-demographic background, clinical history, condition and outcome. The negative dimension was more prominent in male and single patients, the depressive dimension in female and divorced patients. Patients with early onset and long duration of illness had high disorganization scores. Patients with disorganized subtype of schizophrenia had high scores in positive and disorganization dimensions. High scores in all, especially in negative and positive dimensions, were associated with poor psychosocial situation. Symptom dimensions varied also according to treatment setting at follow-up. Symptom dimensions of long-term schizophrenia patients in the community are closely associated with patients' socio-demographic background, clinical history and conditions, as well as with outcome and the treatment patients receive. A dimensional approach, instead of a categorical one, seems to be important in assessing symptomatology and its relation to outcome and interventions in schizophrenia.