Network analysis of psychotic symptoms in schizophrenia

Background: Schizophrenia with a wide range of psychotic symptoms which indicate the severity of disorders, risk of relapse, frequency and duration of hospitalization, and decreases social and occupational function. In clinical practice, Positive and Negative Systems Scale always used for assessment the severity of psychotic symptoms of patients with schizophrenia. This network analysis explores the inter-relationship of psychotic symptoms of patients with based on Positive and Negative Systems Scale (PANSS). Methods: The psychotic symptoms of the patients with schizophrenia were assessed by psychiatrist using PANSS when the first day in hospitalization. The network structure of psychotic symptoms was modelled with a graph and characterized using "Expected Influence" and "Bridge Expected Influence" as influential indices in the symptom network. Network stability was tested using a case-dropping bootstrap procedure. Network Comparison Test (NCT) was conducted to examine whether network characteristics differed on the basis of gender. Results: A total of 799 patients with schizophrenia were included. The mean age of the included participants was 39.51(standard deviation (SD)13.93). The main finding of the study was Preoccupation, Emotional instability and Anxiety were the most influential psychotic symptoms, while Active social avoidance, Emotional instability and Preoccupation were the most bridge influential psychotic symptoms within the interpret-able level of influential in the network. Gender did not significantly affect the overall network structure. Conclusion: This influential (Preoccupation, Emotional instability and Anxiety) and bridge influential symptoms (Active social avoidance, Emotional instability and Preoccupation) dimension could be addressed in treatment target and treatment response for the patients with schizophrenia.