TY - JOUR
T1 - The factor structure and clinical utility of formal thought disorder in first episode psychosis
AU - Roche, Eric
AU - Lyne, John Paul
AU - O'Donoghue, Brian
AU - Segurado, Ricardo
AU - Kinsella, Anthony
AU - Hannigan, Ailish
AU - Kelly, Brendan D.
AU - Malone, Kevin
AU - Clarke, Mary
N1 - Publisher Copyright:
© 2015 Elsevier B.V..
PY - 2015/10/1
Y1 - 2015/10/1
N2 - Background: Formal thought disorder (FTD) is a core feature of psychosis, however there are gaps in our knowledge about its prevalence and factor structure. We had two aims: first, to establish the factor structure of FTD; second, to explore the clinical utility of dimensions of FTD in order to further the understanding of its nosology. Methods: A cross-validation study was undertaken to establish the factor structure of FTD in first episode psychosis (FEP). The relative utility of FTD categories vs. dimensions across diagnostic categories was investigated. Results: The prevalence of clinically significant FTD in this FEP sample was 21%, although 41% showed evidence of disorganised speech, 20% displayed verbosity and 24% displayed impoverished speech. A 3-factor model was identified as the best fit for FTD, with disorganisation, poverty and verbosity dimensions (GFI = 0.99, RMR = 0.07). These dimensions of FTD accurately distinguished affective from non-affective diagnostic categories. A categorical approach to FTD assessment was useful in identifying markers of clinical acuteness, as identified by short duration of untreated psychosis (OR = 2.94, P. <. 0.01) and inpatient treatment status (OR = 3.98, P. <. 0.01). Conclusion: FTD is moderately prevalent and multi-dimensional in FEP. Employing both a dimensional and categorical assessment of FTD gives valuable clinical information, however there may be a need to revise our conceptualisation of the nosology of FTD. The prognostic value of FTD, as well as its neural basis, requires elucidation.
AB - Background: Formal thought disorder (FTD) is a core feature of psychosis, however there are gaps in our knowledge about its prevalence and factor structure. We had two aims: first, to establish the factor structure of FTD; second, to explore the clinical utility of dimensions of FTD in order to further the understanding of its nosology. Methods: A cross-validation study was undertaken to establish the factor structure of FTD in first episode psychosis (FEP). The relative utility of FTD categories vs. dimensions across diagnostic categories was investigated. Results: The prevalence of clinically significant FTD in this FEP sample was 21%, although 41% showed evidence of disorganised speech, 20% displayed verbosity and 24% displayed impoverished speech. A 3-factor model was identified as the best fit for FTD, with disorganisation, poverty and verbosity dimensions (GFI = 0.99, RMR = 0.07). These dimensions of FTD accurately distinguished affective from non-affective diagnostic categories. A categorical approach to FTD assessment was useful in identifying markers of clinical acuteness, as identified by short duration of untreated psychosis (OR = 2.94, P. <. 0.01) and inpatient treatment status (OR = 3.98, P. <. 0.01). Conclusion: FTD is moderately prevalent and multi-dimensional in FEP. Employing both a dimensional and categorical assessment of FTD gives valuable clinical information, however there may be a need to revise our conceptualisation of the nosology of FTD. The prognostic value of FTD, as well as its neural basis, requires elucidation.
KW - Clinical utility
KW - Factor structure
KW - Language
KW - Prevalence
KW - Psychosis
KW - Thought disorder
UR - http://www.scopus.com/inward/record.url?scp=84942368137&partnerID=8YFLogxK
U2 - 10.1016/j.schres.2015.07.049
DO - 10.1016/j.schres.2015.07.049
M3 - Article
C2 - 26260080
AN - SCOPUS:84942368137
SN - 0920-9964
VL - 168
SP - 92
EP - 98
JO - Schizophrenia Research
JF - Schizophrenia Research
IS - 1-2
M1 - 6517
ER -