Creating a map of psychiatric patients based on psychopathological symptom profiles.

Samy Egli, Michael Riedel, Hans-Jürgen Möller, Anton Strauss, Damian Läge
Author Information
  1. Samy Egli: Institute of Psychology, Applied Cognitive Psychology, University of Zurich, Binzmühlestrasse 14/28, Zurich 8050, Switzerland.

Abstract

BACKGROUND: In the current debate about the categorical or dimensional classification of mental disorders many fruitful methods to illustrate one or the other aspect are employed, and suggestions are made to combine the two perspectives.
METHODS: We present such an approach to combine both perspectives at the same time. Based on psychopathological AMDP-symptom profiles, a map of psychiatric patients was calculated by robust nonmetric multidimensional scaling (NMDS).
RESULTS: The sample from the Ludwig-Maximilians University in Munich included the records of patients, who were admitted and discharged in 2002 and 2003 with a diagnosis of either paranoid schizophrenia, (F20.00, N = 24), bipolar affective disorder, current episode manic without psychotic symptoms (F31.1, N = 32) or severe depressive episode without psychotic symptoms (F32.2, N = 78). In the resulting map of patients we found a clear categorical distinction according to the diagnostic groups, but also high regression values of AMDP-syndromes (manic syndrome: r = 0.83, depressive syndrome: r = 0.68, and paranoid-hallucinatory syndrome, r = 0.62).
DISCUSSION: The map of psychiatric patients presents an approach to consider the categorical and dimensional aspects at the same time. We were able to identify meaningful delineations between diagnostic clusters as well as continuous transitions. This method allows the whole psychopathological profile of each individual patient to be considered and also to identify misdiagnosed cases at a glance.

References

  1. Int J Methods Psychiatr Res. 2007;16 Suppl 1:S1-5 [PMID: 17623390]
  2. J Psychiatr Res. 2004 Jan;38(1):17-25 [PMID: 14690767]
  3. J Psychiatr Res. 2007 Nov;41(9):724-36 [PMID: 16762370]
  4. Int J Methods Psychiatr Res. 2007;16 Suppl 1:S6-7 [PMID: 17623396]
  5. Eur Arch Psychiatry Clin Neurosci. 2008 Mar;258 Suppl 1:6-11 [PMID: 18344044]
  6. Psychopathology. 2005 Jul-Aug;38(4):206-10 [PMID: 16145276]
  7. Br J Psychiatry. 2005 Sep;187:221-8 [PMID: 16135858]
  8. Int J Methods Psychiatr Res. 2007;16 Suppl 1:S8-S15 [PMID: 17623398]
  9. Psychopathology. 2006;39(1):1-9 [PMID: 16282713]
  10. Psychopathology. 2008;41(5):286-93 [PMID: 18594163]
  11. Acta Psychiatr Scand. 2004 Jan;109(1):30-7 [PMID: 14674956]
  12. Schizophr Bull. 2007 Jan;33(1):108-12 [PMID: 17158191]
  13. Eur Arch Psychiatry Clin Neurosci. 2012 Apr;262(3):227-38 [PMID: 22065176]
  14. J Psychiatr Res. 1975 Nov;12(3):215-30 [PMID: 1104815]
  15. J Abnorm Psychol. 2005 Nov;114(4):494-504 [PMID: 16351373]
  16. Acta Psychiatr Scand. 2000 Feb;101(2):153-60 [PMID: 10706017]
  17. World Psychiatry. 2007 Jun;6(2):100-1 [PMID: 18235866]
  18. Br J Psychiatry. 2000 Sep;177:233-40 [PMID: 11040884]
  19. Curr Opin Psychiatry. 2005 Nov;18(6):653-8 [PMID: 16639091]
  20. Psychol Med. 1994 Feb;24(1):133-44 [PMID: 8208878]
  21. Am J Psychiatry. 2002 Jun;159(6):968-74 [PMID: 12042185]
  22. Psychopathology. 2005 Jul-Aug;38(4):201-5 [PMID: 16145275]
  23. Schizophr Res. 2001 Dec 1;52(3):215-29 [PMID: 11705715]
  24. Eur Arch Psychiatry Clin Neurosci. 2005 Feb;255(1):15-9 [PMID: 15538595]
  25. Dev Psychopathol. 2003 Summer;15(3):529-51 [PMID: 14582931]
  26. Eur Arch Psychiatry Clin Neurosci. 2006 Dec;256(8):512-5 [PMID: 16960654]
  27. Am J Psychiatry. 2003 Jan;160(1):4-12 [PMID: 12505793]
  28. Comput Biomed Res. 1978 Jun;11(3):277-98 [PMID: 679655]
  29. Methods Inf Med. 1982 Oct;21(4):210-20 [PMID: 6757657]
  30. J Abnorm Psychol. 2005 Nov;114(4):551-6 [PMID: 16351377]
  31. J Abnorm Psychol. 2005 Nov;114(4):522-36 [PMID: 16351375]
  32. Multivariate Behav Res. 1966 Apr 1;1(2):245-76 [PMID: 26828106]
  33. Aust N Z J Psychiatry. 2003 Dec;37(6):696-704 [PMID: 14636384]
  34. Psychol Rev. 2005 Jan;112(1):129-58 [PMID: 15631591]
  35. Int Rev Psychiatry. 2005 Feb;17(1):9-19 [PMID: 16194767]

MeSH Term

Bipolar Disorder
Depressive Disorder
Diagnosis, Differential
Diagnostic Errors
Hospitals
Humans
Patients
Psychiatric Status Rating Scales
Psychopathology
Regression Analysis
Schizophrenia, Paranoid
Severity of Illness Index

Word Cloud

Created with Highcharts 10.0.0=patientsmapcategoricalpsychopathologicalpsychiatricNr0currentdimensionalcombineperspectivesapproachtimeprofilesepisodemanicwithoutpsychoticsymptomsdepressivediagnosticalsosyndrome:identifyBACKGROUND:debateclassificationmentaldisordersmanyfruitfulmethodsillustrateoneaspectemployedsuggestionsmadetwoMETHODS:presentBasedAMDP-symptomcalculatedrobustnonmetricmultidimensionalscalingNMDSRESULTS:sampleLudwig-MaximiliansUniversityMunichincludedrecordsadmitteddischarged20022003diagnosiseitherparanoidschizophreniaF200024bipolaraffectivedisorderF31132severeF32278resultingfoundcleardistinctionaccordinggroupshighregressionvaluesAMDP-syndromes8368paranoid-hallucinatorysyndrome62DISCUSSION:presentsconsideraspectsablemeaningfuldelineationsclusterswellcontinuoustransitionsmethodallowswholeprofileindividualpatientconsideredmisdiagnosedcasesglanceCreatingbasedsymptom

Similar Articles

Cited By