title: The psychopathological factors of refractory schizophrenia.
abstract: OBJECTIVE
  The heterogeneity of clinical manifestations in schizophrenia has lead to the study of symptom clusters through psychopathological assessment scales. The objective of this study was to elucidate clusters of symptoms in patients with refractory schizophrenia which may also help to assess the patients' therapeutical response.
  
  
  METHODS
  Ninety-six treatment resistant patients were evaluated by the anchored version Brief Psychiatric Rating Scale (BPRS-A) as translated into Portuguese. The inter-rater reliability was 0.80. The 18 items of the BPRS-A were subjected to exploratory factor analysis with Varimax rotation.
  
  
  RESULTS
  Four factors were obtained: Negative/Disorganization, composed by emotional withdrawal, disorientation, blunted affect, mannerisms/posturing, and conceptual disorganization; Excitement, composed of excitement, hostility, tension, grandiosity, and uncooperativeness, grouped variables that evoke brain excitement or a manic-like syndrome; Positive, composed of unusual thought content, suspiciousness, and hallucinatory behavior; and Depressive, composed of depressive mood, guilt feelings, and motor retardation, clearly related to depressive syndrome.
  
  
  CONCLUSIONS
  The study reproduced the four factors described in the literature, either in refractory or non-refractory patients. The BPRS-A allowed the distinction of psychopathological factors, which are important in the evaluation of treatment response of patients with schizophrenia.
authors.affiliation: Post-graduate Program in Psychiatry, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Tânia Maria
authors.initials: TM
authors.lastname: Alves
authors.forename: Júlio César Rodrigues
authors.initials: JC
authors.lastname: Pereira
authors.forename: Hélio
authors.initials: H
authors.lastname: Elkis
mesh_terms: D000328:Adult; D000368:Aged; D010054:Brief Psychiatric Rating Scale; D016009:Chi-Square Distribution; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000145:classification / Q000503:physiopathology; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index