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Predominance of Symptoms Over Time in Early-Onset Psychosis: A Principal Component Factor Analysis of the Positive and Negative Syndrome Scale

Marta Rapado-Castro, PhD; Cesar Soutullo, MD, PhD; David Fraguas, MD; Celso Arango, MD, PhD; Beatriz Payá, MD; Josefina Castro-Fornieles, MD, PhD; Ana González-Pinto, MD, PhD; Mara Parellada, MD, PhD; Montserrat Graell, MD; Inmaculada Baeza, MD, PhD; and Igor Bombin, PhD

Published: March 15, 2010

Article Abstract

Background: Early-onset psychosis is a symptomatically nonspecific and heterogeneous entity composed of several diagnoses. This study examined the dimensional structure of symptoms and the temporal stability of this structure during a 6-month follow-up.

Method: A principal component factor analysis of the Positive and Negative Syndrome Scale was conducted at baseline, 4 weeks, and 6 months in a sample of 99 first-episode psychotic patients (mean age = 15.5 years).

Results: The factor analysis produced a 5-dimension solution (Positive, Negative, Depression, Cognitive, Hostility) that explained 62.4% of the variance at baseline, 63.4% at 4 weeks, and 65.1% at 6 months. Negative dimension was the most consistent and stable over time and was predominant at baseline (23.9%) and at 4 weeks (25.7%). Depression was predominant at 6 months (31.1%).

Conclusions: There is a stable 5-dimension structure of symptoms in early-onset psychosis with varying predominance of symptoms over time. Negative symptoms are a core feature of psychosis and are thus important diagnostic criteria.

J Clin Psychiatry 2010;71(3):327-337

Submitted: November 4, 2008; accepted June 3, 2009.

Corresponding author: Marta Rapado-Castro, PhD, Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, C/ Ibiza 43, 28009 Madrid, Spain (

Volume: 71

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