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Vol. 41, No. 2, 2008
Issue release date: December 2007

Consistency of Brief Psychiatric Rating Scale Factor Structure across a Broad Spectrum of Schizophrenia Patients

Kopelowicz A. · Ventura J. · Liberman R.P. · Mintz J.
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Background: The Brief Psychiatric Rating Scale (BPRS) has been the workhorse of psychopathology assessment in studies of schizophrenia and related psychotic disorders for over 40 years. Our goal was to evaluate the discriminant validity of the BPRS across the broad spectrum of persons with schizophrenia. Sampling and Methods: The total sample of 565 subjects with schizophrenia (84%) or schizoaffective disorder (16%) came from eight separate studies conducted under the aegis of the UCLA Clinical Research Center for Schizophrenia and Psychiatric Rehabilitation over a period of 15 years. The total sample could be divided into three subsamples based on illness chronicity and degree of refractoriness to treatment: Recent-onset patients had been ill for less than 2 years (n = 178), stable chronic patients between 2 and 19 years (n = 243) and treatment-refractory patients for more than 19 years (n = 144). Exploratory principal components analysis and varimax rotation were performed on the total sample. The results of each of the three subsamples were compared to the total sample using a correlation matrix and by calculating a coefficient of congruence. Results: A 4-factor solution was considered the most interpretable for each subsample, reflecting the same 4 components identified in the total sample: positive symptoms, negative symptoms, agitation-mania and depression-anxiety. Correlation coefficients and coefficient of congruence were very high, ranging from 0.91 to 0.98. Conclusions: The consistency of the 4-factor solution of the 24-item BPRS across the range of subjects, from first psychotic episode to long-stay, institutionalized patients, supports the use of these factors and this instrument as a whole to track changes over time and with treatment in research and clinical samples.

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  1. Bell MD, Lysaker PH, Beam-Goulet JL, Milstein RM, Lindenmayer JP: Five-component model of schizophrenia: assessing the factoral invariance of the positive and negative syndrome scale. Psychiatry Res 1993;52:295–303.

    External Resources

  2. Dingemans PMAJ, Linszen DH, Lenior ME, Smeets RMW: Component structure of the expanded Brief Psychiatric Rating Scale (BPRS-E). Psychopharmacology 1995;122:263–267.
  3. van der Does AJ, Linszen DH, Dingemans PM, Nugter MA, Scholte WF: A dimensional and categorical approach to the symptomatology of recent-onset schizophrenia. J Nerv Ment Dis 1993;181:744–749.
  4. Mueser KT, Curran PJ, McHugo GJ: Factor structure of the brief psychiatric rating scale in schizophrenia. Psychol Assess 1997;9:196–204.

    External Resources

  5. Thomas A, Donnell AJ, Young TR: Factor structure and differential validity of the expanded Brief Psychiatric Rating Scale. Assessment 2004;11:177–187.
  6. Velligan D, Prihoda T, Dennehy E, Biggs M, Shores-Wilson K, Crismon ML, Rush AJ, Miller A, Suppes T, Trivedi M, Kashner TM, Witte B, Toprac M, Carmody T, Chiles J, Shon S: Brief Psychiatric Rating Scale expanded version: how do new items affect factor structure? Psychiatry Res 2005;135:217–228.
  7. Briggs SR, Cheek JM: The role of factor analysis in the development and evaluation of personality scales. J Personality 1986;54:106–148.

    External Resources

  8. Ventura J, Green MF, Shaner A, Liberman RP: Training and quality assurance in the use of the expanded Brief Psychiatric Rating Scale: the ‘drift busters’. Int J Methods Psychiatry Res 1993;3:221–244.

    External Resources

  9. Ventura J, Nuechterlein KH, Subotnik KL, Gutkind D, Gilbert EA: Symptom dimensions in recent-onset schizophrenia and mania: a principal components analysis of the 24-item Brief Psychiatric Rating Scale. Psychiatry Res 2000;97:129–135.
  10. Nuechterlein KH, Dawson ME, Gitlin M, Ventura J, Goldstein MJ, Snyder KS, Yee CM, Mintz J: Developmental processes in schizophrenic disorders: longitudinal studies of vulnerability and stress. Schizophrenia Bull 1992;18:392–425.
  11. Liberman RP, Wallace CJ, Blackwell G, Kopelowicz A, Vaccaro JV, Mintz J: Skills training versus psychosocial occupational therapy for persons with persistent schizophrenia. Am J Psychiatry 1998;155:1087–1091.
  12. Glynn SM, Marder SR, Liberman RP, Blair K, Wirshing WC, Wirshing DA, Ross D, Mintz J: Supplementing clinic-based skills training with manual-based community support sessions: effects on social adjustment of patients with schizophrenia. Am J Psychiatry 2002;159:829–837.
  13. Green MF, Marshall BD, Wirshing WC, Ames D, Marder SR, McGurk S, Kern RS, Mintz J: Does risperidone improve verbal working memory in treatment-resistant schizophrenia? Am J Psychiatry 1997;154:799–804.
  14. Wirshing DA, Marshall BD, Green MF, Mintz J, Marder SR, Wirshing WC: Risperidone in treatment-refractory schizophrenia. Am J Psychiatry 1999;156:1374–1379.
  15. Green MF, Nuechterlein KH, Mintz J: Backward masking in schizophrenia and mania. I. Specifying a mechanism. Arch Gen Psychiatry 1994;51:939–944.
  16. Green MF, Mintz J, Salveson D, Nuechterlein KH, Breitmeyer B, Light GS, Braff DL: Visual masking as a probe for abnormal gamma range activity in schizophrenia. Biol Psychiatry 2003;53:1113–1119.
  17. Endicott J, Spitzer RL: A diagnostic interview: the Schedule for Affective Disorders and Schizophrenia. Arch Gen Psychiatry 1978;35:837–844.
  18. First MB, Spitzer RL, Gibbon M, Williams JBW: Structured Clinical Interview (SCID) for DSM-IV Axis I Disorders. Washington, American Psychiatric Press, 1997.
  19. Lukoff D, Liberman RP, Nuechterlein KH: Symptom monitoring in the rehabilitation of schizophrenic patients. Schizophrenia Bull 1986;12:578–602.
  20. Ventura J, Liberman RP, Green MF, Shaner A, Mintz J: Training and quality assurance with the Structured Clinical Interview for DSM-IV. Psychiatry Res 1998;79:163–173.
  21. SAS/STAT Software Version 9. Cary, SAS Institute, 2004.
  22. Harman HH: Modern Factor Analysis, ed 2. Chicago, University of Chicago Press, 1967.
  23. Robinson D, Woerner MG, Alvir JM, Bilder R, Goldman R, Geisler S, Koreen A, Sheitman B, Chakos M, Mayerhoff D, Lieberman JA: Predictors of relapse following response from a first episode of schizophrenia or schizoaffective disorder. Arch Gen Psychiatry 1999;56:241–247.
  24. Moller P, Husby R: The initial prodrome in schizophrenia: searching for naturalistic core dimensions of experience and behavior. Schizophrenia Bull 2000;26:217–232.
  25. Rovner BW, Steele DD, German P, Clark R, Folstein MF: Psychiatric diagnosis and uncooperative behavior in nursing homes. J Geriatr Psychiatry Neurol 1992;5:102–105.
  26. Peralta V, Cuesta MJ: Motor features in psychotic disorders. I. Factor structure and clinical correlates. Schizophrenia Res 2001;47:107–116.
  27. Panos PT: The validation of the factor structure of the Brief Psychiatric Rating Scale – expanded version with geriatric and non-geriatric psychiatric inpatients. Res Social Work Pract 2004;14:180–190.

    External Resources

  28. McGorry PD, Bell RC, Dudgeon PL, Jackson HJ: The dimensional structure of first episode psychosis: an exploratory factor analysis. Psychol Med 1998;28:935–947.
  29. Koreen AR, Siris SG, Chakos M, Alvir J, Mayerhoff D, Lieberman J: Depression in first-episode schizophrenia. Am J Psychiatry 1993;150:1643–1648.
  30. Addington D, Addington J, Patten S: Depression in people with first-episode schizophrenia. Br J Psychiatry 1998;172(suppl):90–92.
  31. Emsley RA, Oosthuizen PP, Joubert AF, Roberts MC, Stein DJ: Depressive and anxiety symptoms in patients with schizophrenia and schizophreniform disorder. J Clin Psychiatry 1999;60:747–751.
  32. Hafner H, Maurer K, Trendler G, van der Heiden W, Schmidt M, Konnecke R: Schizophrenia and depression: challenging the paradigm of two separate diseases – A controlled study of schizophrenia, depression and healthy controls. Schizophrenia Res 2005;77:11–24.
  33. Lora A, Consentino U, Rossini MT, Lanzara D: A cluster analysis of patients with schizophrenia in community care. Psychiatr Serv 2001;52:682–684.
  34. Marder SR, Davis JM, Choiunard G: The effects of risperidone on schizophrenia derived by factor analysis: combined results of the North American trials. J Clin Psychiatry 1997;58:538–546.

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