NEGATIVE, PSYCHOTICISM, AND DISORGANIZED DIMENSIONS IN PATIENTS WITH FAMILIAL SCHIZOPHRENIA OR BIPOLAR DISORDER - CONTINUITY AND DISCONTINUITY BETWEEN THE MAJOR PSYCHOSES

Objective: This study aimed to answer the following questions: 1) Can we reliably measure the psychopathologic dimensions of schizophrenia b y wing a lifetime frame and by rating acute and interepisode periods s eparately? 2) Can we reproduce in subjects with familial schizophrenia the characteristic three-factor structure of schizophrenic symptoms t hat has been found previously in general groups of schizophrenic patie nts? 3) Is the factor structure also present in familial bipolar disor der? Method: Lifetime measures of psychotic symptoms were taken throug h a slightly modified version of the Comprehensive Assessment of Sympt oms and History for 138 patients with highly familial DSM-III-R schizo phrenia (N=51), bipolar disorder (N=44), or spectrum disorders (N=43). Symptoms were rated separately in the acute episodes and in the stabi lized interepisode intervals across the patients' lives. Results: A sa tisfactory level of reliability was obtained. In this highly familial study group, the positive/negative factorial distinction was replicate d as was a three-factor model similar to that observed in prior genera l groups of schizophrenic patients. These factors were also present in bipolar affective disorder. The negative, psychoticism, and disorgani zed factor model applied move to the acute phase of illness than to th e stabilized state. Conclusions: These findings offer an empirical bas is for testing biological or genetic variables in relation to negative /positive symptom dimensions, rather than diagnoses. Observations of a shared structure for schizophrenia and bipolar disorder suggest some continuity in the causes of these disorders.