Comparing the DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure-Adult across B-SNIP2 biotypes

Tabinda Khan, BA

Beth Israel Deaconess Medical Center – Research Assistant

Scientific Abstract

Background: The Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium created new psychosis categories called “biotypes” that were based on biological markers rather than clinical phenomenology. Biotype 1 was most comparable to chronic cases of schizophrenia with profound dysfunction on cognitive control, while Biotype 2, with less dysfunction on cognitive control, was marked by prominent sensorimotor reactivity. In contrast, Biotype 3 showed less severe clinical psychosis symptomology and nearly normal cognition and sensorimotor reactivity. The DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure-Adult is a self-rated questionnaire to assess patient psychiatric symptoms over a range of mental health issues.  Patients rate how bothered they have been by 23 symptoms over the past 2 weeks.  They score 0 (none), 1 (slight), 2 (mild), 3 (moderate), or 4 (severe). This measure is meant to flag mental health domains for clinicians to further investigate, including depression, anger, mania, anxiety, somatic symptoms, suicidal ideation, psychosis, sleep problems, memory issues, repetitive thoughts and behaviors, dissociation, personality functioning, and substance use.

Methods: 69 adults (aged 18-60) from the B-SNIP2 Study Boston site with SCID–IV diagnosed psychotic disorders completed the DSM-5 Cross-Cutting Symptom Measure. Several other biomarker assessments were collected to categorize into biotypes. One-way ANOVAs were run to explore differences between biotypes for each Cross-Cutting Symptom domain.

Results: We found a statically significant difference (p<0.05) between biotypes in the cross-cutting domain of Memory F(2)=2.54, p=0.047. We ran multiple comparisons of means using a post-hoc test resulting in an adjusted p-value of 0.076 with 95% confidence level. A Turkey post-hoc test revealed that Biotype 1 had much higher cross-cutting scores on average than Biotype 2 (diff=1.13). There were no statistically significant differences across biotypes for any of the other Cross-cutting domains.

Conclusions: Biotype 1 had more highly impaired scores than Biotype 2 on the Cross-cutting symptom domain of Memory. There were no other significant differences among the biotypes for any of the other domains. Many more participants in Biotype 1 found problems with memory more bothersome than those in Biotype 2.

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research Areas


Tabinda Khan, BA, Courtney Spitzer, BA, Gautami Shashidhar, BA, Matcheri Keshavan, MD

Principal Investigator

Matcheri Keshavan, MD