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  • Title: Dimensions underlying psychotic and manic symptomatology: Extending normal-range personality traits to schizophrenia and bipolar spectra.
    Author: Wilson S, Sponheim SR.
    Journal: Compr Psychiatry; 2014 Nov; 55(8):1809-19. PubMed ID: 25091283.
    Abstract:
    OBJECTIVE: Covariance among psychiatric disorders can be accounted for by higher-order internalizing, externalizing, and psychosis dimensions, but placement of bipolar disorder within this framework has been inconsistent. Moreover, whether deviations in normal-range personality can explain psychosis and vulnerability to severe mood lability, as seen in schizophrenia and bipolar disorder, remains unclear. METHODS: Exploratory factor analysis of interviewer-rated clinical symptoms in patients with schizophrenia or bipolar disorder, their first-degree biological relatives, and nonpsychiatric controls (total N=193), followed by examination of associations between symptom dimensions and self reports on personality questionnaires. RESULTS: Covariance in symptoms was accounted for by five factors: positive symptoms of psychosis, negative symptoms of psychosis, disorganization, mania, and depression/anxiety. Schizophrenia and bipolar patients/relatives reported elevated negative emotionality and absorption and lower positive emotionality relative to controls. Personality did not differ between schizophrenia and bipolar patients/relatives, but there was a different pattern of associations between symptoms and personality in these groups. CONCLUSIONS: Discrete dimensions reflecting psychotic, manic, and depressive symptoms emerge when a broad set of clinical symptoms is examined in a sample overrepresented by psychotic experiences and affective disturbances. Although normal-range personality traits index common phenotypes spanning schizophrenia and bipolar spectra, the same symptoms may carry different significance across disorders.
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