A Longitudinal Study of Symptom Dimensions in Schizophrenia: Prediction and Patterns of Change

doi:10.1001/archpsyc.1995.03950170026004

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Vol. 52 No. 5, May 1995

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A Longitudinal Study of Symptom Dimensions in Schizophrenia

Prediction and Patterns of Change

Stephan Arndt, PhD; Nancy C. Andreasen, MD, PhD; Michael Flaum, MD; Del Miller, PharmD, MD; Peg Nopoulos, MD

Arch Gen Psychiatry. 1995;52(5):352-360.

Abstract

Background
Factor analytic studies have suggested that the symptoms ofschizophrenia may be divided into three uncorrelated dimensions.This study examines the longitudinal course of the symptomsof schizophrenia using this three-dimensional perspective.

Methods
The sample was composed primarily ofneuroleptic-naive patientssuffering from schizophrenia. Subjects were studied in a prospectivelongitudinal design, with comprehensive structured assessmentsat index, discharge, and 6-month intervals after discharge overa 2-year period.

Results
Negative symptoms were already relatively prominent at the timeof index evaluation; they tended to remain stable throughoutthe follow-up period. The two dimensions of positive symptoms,psychoticism and disorganization, although prominent at indexevaluation, declined over the course of the follow-up periodand tended to be less stable. A longitudinal factor analysiswas conducted to determine whether the changes in symptoms followedany consistent pattern. We observed that all three groups ofsymptoms tended to change in unison and independently from oneanother.

Conclusions
These results suggest that these three dimensions of psychopathologyshow different patterns of exacerbation and remission duringthe course of schizophrenia. This independent pattern of evolutionsuggests that these three dimensions should be studied furtherwith respect to response to treatment, cognitive mechanisms,psychosocial correlates, and neural substrates.

Author Affiliations

From the Mental Health Clinical Research Center (Drs Arndt, Andreasen, Flaum, Miller, and Nopoulos) and the Departments of Preventive Medicine and Environmental Health (Dr Arndt) and Psychiatry (Drs Andreasen, Flaum, Miller, and Nopoulos), The University of Iowa Hospitals and Clinics, Iowa City.

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