Background and Hypothesis There has been a century-long debate about whether the major psychoses (eg, bipolar disorder, schizophrenia, and schizoaffective disorder) are one disorder with various manifestations or different disease entities. Traditional approaches using dimensional models have not provided decisive findings. Here, we address this question by examining the network constellation of affective and psychotic syndromes. Design Comparable symptom data of 1882 patients with psychotic bipolar disorder, schizoaffective disorders, and schizophrenia were extracted from three datasets: B-SNIP 1, B-SNIP2, and PARDIP. Twenty-six items from the Positive and Negative Syndrome Scale, YMRS, and the Montgomery-Asberg Depression Rating Scale were selected for the analysis using a principled approach to eliminate overlapping/redundant items. Gaussian graphical models were estimated and assessed for stability, and their communities were identified using bootstrapped exploratory graph analysis. The structures and global densities of the networks were compared with network comparison tests. Results The network structures were highly similar (r >. 80) across diagnostic groups. For all diagnoses, manic symptoms were more connected with positive symptoms while depressive symptoms were more linked with negative symptoms. The depressive and negative symptoms were the strongest indicators of depressive and psychotic communities. Theoretically interesting variability in network edge weights between symptoms was found relating to thought disorder and pessimistic thinking. Conclusions The same broad structure of psychopathology underlies the symptom expressions of bipolar disorder, schizoaffective disorder, and schizophrenia. Future studies should build on the present finding by comparing specific inter-relations between symptoms in the different diagnostic groups using methods capable of detecting causality.

中文翻译：

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主要精神病的共同结构：精神分裂症、分裂情感性障碍和精神病性双相情感障碍的网络结构的相似性多于差异


背景和假设 关于主要精神病（例如双相情感障碍、精神分裂症和分裂情感障碍）是否是一种具有多种表现形式的疾病或不同的疾病实体，这一问题已经争论了一个世纪。使用维度模型的传统方法尚未提供决定性的发现。在这里，我们通过检查情感和精神病综合征的网络星座来解决这个问题。设计 从三个数据集中提取了 1882 名精神病性双相情感障碍、分裂情感性障碍和精神分裂症患者的可比症状数据：B-SNIP 1、B-SNIP2 和 PARDIP。使用原则性方法从阳性和阴性综合症量表、YMRS 和蒙哥马利-阿斯伯格抑郁评定量表中选择 26 个项目进行分析，以消除重叠/冗余项目。对高斯图模型的稳定性进行了估计和评估，并使用引导探索性图分析来识别它们的群落。通过网络比较测试对网络的结构和全局密度进行了比较。结果 各诊断组的网络结构高度相似 (r >.80)。对于所有诊断，躁狂症状与阳性症状更相关，而抑郁症状与阴性症状更相关。抑郁和阴性症状是抑郁和精神病社区的最强指标。理论上，症状之间的网络边缘权重存在有趣的变化，这与思维障碍和悲观思维有关。结论 双相情感障碍、分裂情感性障碍和精神分裂症的症状表现具有相同的精神病理学结构。 未来的研究应该以目前的发现为基础，使用能够检测因果关系的方法来比较不同诊断组中症状之间的具体相互关系。