Basic symptoms and psychotic symptoms: Their relationships in the at risk mental states, first episode and multi-episode schizophrenia Anna Comparelli a, ⁎ , Antonella De Carolis b , Emanuele Emili a , Silvia Rigucci a , Ilaria Falcone a , Valentina Corigliano a , Martina Curto a , Giada Trovini a , Julia Dehning a , Giorgio D. Kotzalidis a , Paolo Girardi a a NESMOS Department (Neurosciences, Mental Health and Sense Organs) Unit of Psychiatry, Sant’Andrea Hospital, School of Medicine and Psychology, Sapienza University of Rome, Italy b NESMOS Department (Neurosciences, Mental Health and Sense Organs) Unit of Neurology, Sant’Andrea Hospital, School of Medicine and Psychology, Sapienza University of Rome, Italy Abstract In the field of the early psychosis two main approaches attempt to develop rating tools, one investigating the basic symptoms domain, and the other the attenuated psychotic symptoms. To explore the relationship between basic symptoms (BSs) and other symptom domains in different phases of the psychotic illness 32 at ultra-high risk (UHR), 49 first episode schizophrenia (FES), 42 multiple episode schizophrenia (MES), and 28 generalized anxiety disorder (GAD) patients were enrolled. Participants were assessed using the SIPS/SOPS and the FCQ scales. Analyses of covariance taking into account socio-demographic and clinical variables significantly different between groups were applied to compare FCQ and SOPS scores. Finally FCQ and SOPS principal component analysis was carried out in the schizophrenia spectrum group. SOPS scores were higher in the UHR, FES and MES groups compared to the GAD control group. Concordantly, FES and MES groups had a higher number of basic symptoms in comparison with the GAD group, whereas UHR did not differ from the control group. The largest number of correlations between BSs and psychotic symptoms was found in the GAD group. According to the principal component analysis (PCA) five factors were extracted, with the BSs loading on a unique factor. Our findings imply that the boundary between psychotic and non-psychotic conditions cannot be outlined on the basis of the presence/absence of basic and psychotic symptoms. © 2014 Elsevier Inc. All rights reserved. 1. Introduction Schizophrenia is considered as a chronic disorder causing severe personal and social dysfunction. The disorder encompasses multiple phases that presumably are the phenotypes of a progressive, direction-endowed, neurode- velopmental disorder. Symptoms progression, starting from non-specific, negative, or sub-threshold symptoms, consid- ered as the prodrome of the disorder, have been noted since Kraepelin’s times, but only recently have they been systematically described [1,2]. In the field of early detection of psychosis there are two main approaches attempting to develop rating tools, one based on the basic symptoms concept, and the other on the attenuated psychosis concept. Basic symptoms are subtle, subclinical, although distressing self-experienced disturbances in perception, thinking, mem- ory, motility, mood, sense of awareness and mastering, clearly distinguishable from attenuated or frank psychotic symptoms [3]. The other approach is based on the detection of positive symptoms and allows to define three ultra-high- risk (UHR) groups, i.e., Group 1 (Trait and State Risk Factor), Group 2 (Attenuated Psychotic Symptoms, APS), and Group 3 (Brief Limited Intermittent Psychotic Symp- toms, BLIPS) [4,5]. Integrating models based on multiple predictors, predictive power increases [6] and this holds true when the UHR approach is integrated with the basic symptom approach [7]. The specificity and sensitivity of basic symptoms and attenuated psychotic symptoms as to the development of psychosis have been tested in a number of studies. According to the Bonn school, basic symptoms show high sensitivity but poor specificity [8]. On the other hand, Available online at www.sciencedirect.com ScienceDirect Comprehensive Psychiatry 55 (2014) 785 – 791 www.elsevier.com/locate/comppsych ⁎ Corresponding author. Tel.: +39 06 33775664. E-mail address: anna.comparelli@uniroma1.it (A. Comparelli). 0010-440X/$ – see front matter © 2014 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.comppsych.2014.01.006