Factor Structure of the Bern Psychopathology Scale in a Sample of Patients with Schizophrenia Spectrum Disorders

Lang, Fabian; Stierlin, Annabel S.; Stegmayer, Katharina; Walther, Sebastian; Becker, Thomas; Jäger, Markus

doi:10.1016/j.eurpsy.2015.07.010

Cited by 15 publications

(10 citation statements)

References 19 publications

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“…Recently, a cluster analysis identified six clusters for the system-specific approach of the BPS, consisting mainly of the respective inhibited and disinhibited states of the three domains. This finding supports the conceptual validity of the BPS [23] ( fig. 1 ).…”

Section: Introductionsupporting

confidence: 79%

Psychopathological Course Typology in Schizophrenia Spectrum Disorders: A Heuristic Approach in a Sample of 100 Patients

Wigand

Lang²,

Becker³

et al. 2016

Psychopathology

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Background: Despite several previous attempts at subtyping schizophrenia, a typology that reflects neurobiological knowledge and reliably predicts course and outcome is lacking. We applied the system-specific concept of the Bern Psychopathology Scale (BPS) to generate a course typology based on three domains: language, affectivity, and motor behaviour. Sampling and Methods: A cohort of 100 patients with schizophrenia or schizoaffective disorders according to DSM-IV criteria underwent psychopathological assessment, and all their available medical records were retrospectively analysed on the basis of the BPS. Results: Overall, 39% of the patients showed dominant abnormalities in only one domain, 37% in two domains, and 24% in all three domains. The motor domain was affected in the majority of patients (76%), followed by affectivity (63%) and language (46%). Eighty-six percent of patients showed a bipolar course pattern in at least one domain. Conclusions: In a retrospective analysis of 100 patient records we described system-specific course patterns of schizophrenia by using a neurobiologically informed psychopathological assessment. The results showed a surprisingly high proportion of bipolar courses and a pattern of pure and mixed subtypes, which speaks for an overlap of domains with regards to psychopathological symptoms. A limitation of this heuristic and retrospective approach is that it was largely based on clinical judgement. Prospective studies with more rigorous threshold definitions are needed to clarify the neurobiological and clinical implications of the proposed reorganization of psychotic disorders.

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Section: Introductionsupporting

confidence: 79%

Psychopathological Course Typology in Schizophrenia Spectrum Disorders: A Heuristic Approach in a Sample of 100 Patients

Wigand

Lang²,

Becker³

et al. 2016

Psychopathology

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“…We have, in fact, found activation of the inferior frontal gyrus (Broca's region) during meaningful hand gestures [12], suggesting a contribution of the language network to any semantic expression. On the other hand, we have found clear covariations between disorders of the motor and the language domain in the BPS [6,13]. It will be hard scientific work of multiple disciplines to understand whether these and other functional overlaps are based on low-level, anatomically "hard-wired" shortcuts between the systems at the basal ganglia or cortical level, or the result of cumbersome learning like linking our language capacities to visual object recognition (reading) and fine motor behavior (writing).…”

mentioning

confidence: 87%

SyNoPsis: Response to the Commentators

Strik¹,

Stegmayer²,

Walther³

et al. 2017

Neuropsychobiology

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In their commentary, Manuel Cuesta and Víctor Peralta [1] acknowledge several of the basic contributions and challenges of our SyNoPsis project. They appreciate the attempt to link clinical manifestations with the neurobiology of schizophrenia by means of a revised semiology, and the proposal to understand its essence as a disorder of interpersonal communication. The authors also recognize the aspects contributed by the important work of Carl Wernicke and Karl Leonhard [2,3]. Also, they carve out some relevant limitations of SyNoPsis. Although a relationship of specific symptom dimensions to the respective sensorimotor and corticostriatal brain systems has been shown in several studies [4], the functional specificity of these systems has yet to be defined [5]. Further, different within-systems dynamics may result in different symptom patterns, and the anatomical connections and functional interactions between the systems have not yet been sufficiently understood.In their commentary, Cuesta and Peralta raise two critical clinical aspects: the course of the illness, and the representation of negative symptoms. We agree that the course of psychotic disorders is of eminent importance for clinical management, but also for understanding the long-term dynamics of the brain systems involved. In fact, our clinical instrument, the Bern Psychopathology Scale (BPS) [6], was designed as an instrument for crosssectional assessment. However, it allows recurrent assessments at deliberate intervals for follow-up observations. First retrospective studies have recently been published [7], and the issue of the course of psychosis dimensions will be addressed in detail in future projects.Regarding negative symptoms, we pursued a novel approach, mapping "negative" behavior onto inhibitory states of the respective brain functions. Following our objective to revise the semiology of psychosis based on the best of our knowledge about the related brain functions, this group of symptoms was disentangled respecting the boundaries of higher brain functions. For instance, we conceptualize alogia as "inhibition of verbal expression," and avolition as "lack of spontaneous actions." Thus, negative symptoms are redefined according to the tripartite symptom structure of SyNoPsis to match dysfunctions of the three brain circuits in question. In fact, most overlap was found between the motor dimension and negative symptoms [8].

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“…Psychopathological symptoms of schizophrenic disorders are divided into three domains (language, affect, motor behavior) that are hypothesized to be related to specific brain circuits (language system, limbic system, motor system). In fact several neurobiological findings support this assumption for the language domain [12], for the affect domain [13,14] and for the motor behavior domain [15,16]. The Bern Psychopathology Scale (BPS) is the assessment tool for the system-specific approach [11].…”

Section: Introductionmentioning

confidence: 96%

“…Internal consistency and item discrimination were found to be moderate to excellent [11], and therefore the psychometric scale can be regarded as sound. Furthermore, a recent cluster analysis has identified 6 clusters for the system-specific approach of the BPS, consisting mainly of the inhibited and disinhibited forms of the 3 domains affect, language, and motor behavior [12], which argues for the validity of the BPS. …”

Section: Methodsmentioning

confidence: 99%

Psychopathological Symptoms Assessed by a System-Specific Approach Are Related to Global Functioning in Schizophrenic Disorders

Lang

Müller-Stierlin²,

Walther³

et al. 2016

Psychopathology

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Background: By mostly using a positive-negative approach, several studies have identified factors that influence day-to-day functioning. We applied a different, system-specific approach to expand the knowledge of this issue. Sampling and Methods: We recruited a sample of 100 inpatients with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder. Psychopathological characteristics were assessed with the Bern Psychopathology Scale (BPS) and functional characteristics with the Global Assessment of Functioning (GAF) scale. Linear regression analyses were performed with the GAF score as the dependent variable and the global values of the BPS subscores as independent variables. The model was controlled for confounding variables. Spearman rank correlation analyses were used to identify associations between the relevant BPS subdomains and global functioning. Results: Higher absolute global values of the BPS domains language (p = 0.038) and motor behavior (p = 0.049) were significantly associated with lower GAF scores. These findings remained stable after adjusting for potential confounding variables. A statistically significant negative correlation was found between both qualitative symptoms (r = -0.273, p = 0.006) and indirect signs (r = -0.269, p = 0.007) of the language domain and GAF scores. Also, quantitative (r = -0.211, p = 0.035) and qualitative symptoms (r = -0.214, p = 0.033) in the motor behavior domain were associated with poorer functioning. Conclusions: A system-specific approach can describe subgroups of patients with poor functioning. Identifying such subgroups could help to utilize targeted treatment opinions in a timely manner. Another goal of future research is to clarify the underlying neurobiological deficits.

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Factor Structure of the Bern Psychopathology Scale in a Sample of Patients with Schizophrenia Spectrum Disorders

Cited by 15 publications

References 19 publications

Psychopathological Course Typology in Schizophrenia Spectrum Disorders: A Heuristic Approach in a Sample of 100 Patients

Psychopathological Course Typology in Schizophrenia Spectrum Disorders: A Heuristic Approach in a Sample of 100 Patients

SyNoPsis: Response to the Commentators

Psychopathological Symptoms Assessed by a System-Specific Approach Are Related to Global Functioning in Schizophrenic Disorders

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