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Use of the Domains of Psychopathology Model

Santhi Ratakonda, MD; Jack M. Gorman, MD; Scott A. Yale, MSW; Xavier F. Amador, PhD

Arch Gen Psychiatry. 1998;55:75-81.

Background  Previous factor analytic studies of patients with schizophrenia have consistently demonstrated the presence of 3 psychopathological domains labeled positive, negative, and disorganized. This study examined whether similar domains can be seen in disorders other than schizophrenia, and the degree to which such domains are independent of diagnostic categorization.

Methods  Data from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) field trial involving 221 patients with schizophrenia and 189 patients with nonschizophrenia diagnoses were factor analyzed to study the nature of psychopathological domains in the 2 groups. Differential associations between each domain and selected clinical variables were assessed.

Results  Factor analysis yielded a similar 3-factor model of positive, negative, and disorganization domains for patients with schizophrenia as well as other diagnoses. Differential associations found between individual domains and clinical variables (premorbid functioning and negative domain; absence of remissions and disorganization domain) were similar in both schizophrenia and nonschizophrenia groups.

Conclusions  The 3 psychopathological domains previously described in schizophrenia are not specific for that diagnosis. Differential associations found between individual domains and clinical variables were not limited by diagnostic categorization. The results suggest that these domains are not unique to schizophrenia and may each correspond to a discrete pathophysiologic condition.

From the Division of Diagnosis and Evaluation, Department of Clinical Psychobiology, New York State Psychiatric Institute (Drs Ratakonda, Gorman, and Amador and Mr Yale), and Department of Psychiatry, Columbia University College of Physicians and Surgeons (Drs Ratakonda, Gorman, and Amador), New York, NY, and Schizophrenia Research Unit, Creedmoor Psychiatric Center, Queens, NY (Dr Ratakonda).

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