A dimensional approach to psychosis: identifying cognition, depression, and thought disorder factors in a clinical sample

Abstract Traditional classification systems based on broad nosological categories do not adequately capture the high heterogeneity of mental illness. One possible solution to this is to move to a multi-dimensional model of mental illness, as has been proposed by the Research Domain Criteria and Hier...

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Main Authors: Mikkel Schöttner Sieler, Philippe Golay, Sandra Vieira, Luis Alameda, Philippe Conus, Paul Klauser, Raoul Jenni, Jagruti Patel, Thomas A. W. Bolton, Patric Hagmann
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Schizophrenia
Online Access:https://doi.org/10.1038/s41537-025-00641-x
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author Mikkel Schöttner Sieler
Philippe Golay
Sandra Vieira
Luis Alameda
Philippe Conus
Paul Klauser
Raoul Jenni
Jagruti Patel
Thomas A. W. Bolton
Patric Hagmann
author_facet Mikkel Schöttner Sieler
Philippe Golay
Sandra Vieira
Luis Alameda
Philippe Conus
Paul Klauser
Raoul Jenni
Jagruti Patel
Thomas A. W. Bolton
Patric Hagmann
author_sort Mikkel Schöttner Sieler
collection DOAJ
description Abstract Traditional classification systems based on broad nosological categories do not adequately capture the high heterogeneity of mental illness. One possible solution to this is to move to a multi-dimensional model of mental illness, as has been proposed by the Research Domain Criteria and Hierarchical Taxonomy of Psychopathology frameworks. In this study, we explored the dimensional structure of psychotic disorders. We focused on the question whether combining measures of psychosis with cognitive and depression-related measures results in meaningful, clinically relevant, and valid latent dimensions in a sample of early psychosis (n = 113) and chronic schizophrenia patients (n = 43, total n = 156). We used exploratory factor analysis to identify the symptom dimensions in the Lausanne Psychosis data, a multi-modal prospective data set that includes a broad behavioral assessment of patients diagnosed with psychotic disorders. We evaluated the validity of these dimensions by regressing them to several functioning measures. Our analysis revealed three dimensions: Cognition, Depression/Negative, and Thought Disorder, explaining 49.2% of the variance. They were related to measures of functioning, the R² ranging between 0.38 and 0.42. This study advances the development of a multi-dimensional characterization of psychotic disorders by identifying three symptom dimensions with predictive validity in people with psychosis.
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spelling doaj-art-3d935903fce24aebb49ee5eaa1c92f702025-08-20T03:05:09ZengNature PortfolioSchizophrenia2754-69932025-07-011111810.1038/s41537-025-00641-xA dimensional approach to psychosis: identifying cognition, depression, and thought disorder factors in a clinical sampleMikkel Schöttner Sieler0Philippe Golay1Sandra Vieira2Luis Alameda3Philippe Conus4Paul Klauser5Raoul Jenni6Jagruti Patel7Thomas A. W. Bolton8Patric Hagmann9Department of Radiology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL)General Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne (CHUV-UNIL)Department of Radiology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL)General Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne (CHUV-UNIL)General Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne (CHUV-UNIL)Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne (CHUV-UNIL)Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne (CHUV-UNIL)Department of Radiology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL)Department of Radiology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL)Department of Radiology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL)Abstract Traditional classification systems based on broad nosological categories do not adequately capture the high heterogeneity of mental illness. One possible solution to this is to move to a multi-dimensional model of mental illness, as has been proposed by the Research Domain Criteria and Hierarchical Taxonomy of Psychopathology frameworks. In this study, we explored the dimensional structure of psychotic disorders. We focused on the question whether combining measures of psychosis with cognitive and depression-related measures results in meaningful, clinically relevant, and valid latent dimensions in a sample of early psychosis (n = 113) and chronic schizophrenia patients (n = 43, total n = 156). We used exploratory factor analysis to identify the symptom dimensions in the Lausanne Psychosis data, a multi-modal prospective data set that includes a broad behavioral assessment of patients diagnosed with psychotic disorders. We evaluated the validity of these dimensions by regressing them to several functioning measures. Our analysis revealed three dimensions: Cognition, Depression/Negative, and Thought Disorder, explaining 49.2% of the variance. They were related to measures of functioning, the R² ranging between 0.38 and 0.42. This study advances the development of a multi-dimensional characterization of psychotic disorders by identifying three symptom dimensions with predictive validity in people with psychosis.https://doi.org/10.1038/s41537-025-00641-x
spellingShingle Mikkel Schöttner Sieler
Philippe Golay
Sandra Vieira
Luis Alameda
Philippe Conus
Paul Klauser
Raoul Jenni
Jagruti Patel
Thomas A. W. Bolton
Patric Hagmann
A dimensional approach to psychosis: identifying cognition, depression, and thought disorder factors in a clinical sample
Schizophrenia
title A dimensional approach to psychosis: identifying cognition, depression, and thought disorder factors in a clinical sample
title_full A dimensional approach to psychosis: identifying cognition, depression, and thought disorder factors in a clinical sample
title_fullStr A dimensional approach to psychosis: identifying cognition, depression, and thought disorder factors in a clinical sample
title_full_unstemmed A dimensional approach to psychosis: identifying cognition, depression, and thought disorder factors in a clinical sample
title_short A dimensional approach to psychosis: identifying cognition, depression, and thought disorder factors in a clinical sample
title_sort dimensional approach to psychosis identifying cognition depression and thought disorder factors in a clinical sample
url https://doi.org/10.1038/s41537-025-00641-x
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