{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T15:11:44Z","timestamp":1788793904083,"version":"build-2803163510"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Schizophr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The Positive and Negative Syndrome Scale (PANSS) groups symptoms into three categories, but factor analyses suggest five dimensions with superior psychometric properties. Exploratory graph analysis (EGA) offers a novel network-based approach that provides additional information such as connection of domains, bridge symptoms, and centrality measures. We applied EGA to PANSS data from 1213 participants with schizophrenia at baseline and after six weeks of treatment. We identified symptom clusters with community detection algorithms, item stability with bootstrapping, and the connecting role of individual items with bridge centrality metrics. EGA consistently revealed five communities: positive symptoms, negative symptoms, cognitive disorganization, depression\/anxiety, and hostility\/excitement. The latter was less stable and its symptom P6 (suspiciousness) moved to the positive symptom domain at endpoint. Other item assignments were stable, except for items P5 (grandiosity), and G8 (uncooperativeness). P4 (excitement), P6, G8, and G15 (preoccupation) emerged as key bridge symptoms. Overall, the replication of five factors with a different method underlines their clinical importance.<\/jats:p>","DOI":"10.1038\/s41537-026-00799-y","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T14:45:39Z","timestamp":1788792339000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Revisiting symptom dimensions in schizophrenia with exploratory graph analysis"],"prefix":"10.1038","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1418-250X","authenticated-orcid":false,"given":"Susan","family":"Illing","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4934-4352","authenticated-orcid":false,"given":"Stefan","family":"Leucht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"799_CR1","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1093\/schbul\/13.2.261","volume":"13","author":"SR Kay","year":"1987","unstructured":"Kay, S. R., Fiszbein, A. & Opler, L. A. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr. Bull. 13, 261\u2013276 https:\/\/doi.org\/10.1093\/schbul\/13.2.261 (1987).","journal-title":"Schizophr. Bull."},{"key":"799_CR2","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1136\/bmj.280.6207.66","volume":"280","author":"TJ Crow","year":"1980","unstructured":"Crow, T. J. Molecular pathology of schizophrenia: more than one disease process? Br. Med. J. 280, 66\u201368 https:\/\/doi.org\/10.1136\/bmj.280.6207.66 (1980).","journal-title":"Br. Med. J."},{"key":"799_CR3","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2025.103155","volume":"82","author":"S Geck","year":"2025","unstructured":"Geck, S. et al. COSMIN systematic review and meta-analysis of the measurement properties of the Positive and Negative Syndrome Scale (PANSS). EClinicalMedicine 82, 103155 https:\/\/doi.org\/10.1016\/j.eclinm.2025.103155 (2025).","journal-title":"EClinicalMedicine"},{"key":"799_CR4","doi-asserted-by":"publisher","unstructured":"Mortimer, A. M. Symptom rating scales and outcome in schizophrenia. Br. J. Psychiatry. s7-s14 https:\/\/doi.org\/10.1192\/bjp.191.50.s7 (2007).","DOI":"10.1192\/bjp.191.50.s7"},{"key":"799_CR5","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1038\/s41537-025-00600-6","volume":"11","author":"M Roithmeier","year":"2025","unstructured":"Roithmeier, M. et al. COSMIN review of the PANSS Marder factor solution and other factor models in people with schizophrenia. Schizophrenia 11, 51 https:\/\/doi.org\/10.1038\/s41537-025-00600-6 (2025).","journal-title":"Schizophrenia"},{"key":"799_CR6","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1016\/j.schres.2012.01.031","volume":"137","author":"RS Wallwork","year":"2012","unstructured":"Wallwork, R. S., Fortgang, R., Hashimoto, R., Weinberger, D. R. & Dickinson, D. Searching for a consensus five-factor model of the Positive and Negative Syndrome Scale for schizophrenia. Schizophr. Res. 137, 246\u2013250 https:\/\/doi.org\/10.1016\/j.schres.2012.01.031 (2012).","journal-title":"Schizophr. Res."},{"key":"799_CR7","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1016\/j.schres.2006.03.021","volume":"85","author":"M van der Gaag","year":"2006","unstructured":"van der Gaag, M. et al. The five-factor model of the Positive and Negative Syndrome Scale II: a ten-fold cross-validation of a revised model. Schizophr. Res. 85, 280\u2013287 https:\/\/doi.org\/10.1016\/j.schres.2006.03.021 (2006).","journal-title":"Schizophr. Res."},{"key":"799_CR8","doi-asserted-by":"publisher","first-page":"538","DOI":"10.4088\/jcp.v58n1205","volume":"58","author":"SR Marder","year":"1997","unstructured":"Marder, S. R., Davis, J. M. & Chouinard, G. The effects of risperidone on the five dimensions of schizophrenia derived by factor analysis: combined results of the North American trials. J. Clin. Psychiatry 58, 538\u2013546 https:\/\/doi.org\/10.4088\/jcp.v58n1205 (1997).","journal-title":"J. Clin. Psychiatry"},{"key":"799_CR9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajp.2025.104454","volume":"107","author":"P Cheng","year":"2025","unstructured":"Cheng, P., Liu, Z., Wang, F., Yang, J. & Yang, J. Exploring the associations between psychiatric symptoms and cognitive functions in first-episode schizophrenia: a network analysis. Asian J. Psychiatry 107, 104454 https:\/\/doi.org\/10.1016\/j.ajp.2025.104454 (2025).","journal-title":"Asian J. Psychiatry"},{"key":"799_CR10","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1038\/s41537-024-00499-5","volume":"10","author":"F Dal Santo","year":"2024","unstructured":"Dal Santo, F. et al. The dimensional structure of the Positive and Negative Syndrome Scale in first-episode schizophrenia spectrum disorders: an Exploratory Graph Analysis from the OPTiMiSE trial. Schizophrenia 10, 81 https:\/\/doi.org\/10.1038\/s41537-024-00499-5 (2024).","journal-title":"Schizophrenia"},{"key":"799_CR11","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.schres.2025.11.010","volume":"287","author":"PHM Serafim","year":"2026","unstructured":"Serafim, P. H. M. et al. The challenges in measuring symptoms of schizophrenia: an exploratory graph analysis of the Positive and Negative Syndrome Scale (PANSS). Schizophr. Res. 287, 46\u201353, https:\/\/doi.org\/10.1016\/j.schres.2025.11.010 (2026).","journal-title":"Schizophr. Res."},{"key":"799_CR12","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1093\/schbul\/sbac131","volume":"49","author":"Y Sun","year":"2023","unstructured":"Sun, Y. et al. Longitudinal network analysis reveals interactive change of schizophrenia symptoms during acute antipsychotic treatment. Schizophr. Bull. 49, 208\u2013217 https:\/\/doi.org\/10.1093\/schbul\/sbac131 (2023).","journal-title":"Schizophr. Bull."},{"key":"799_CR13","doi-asserted-by":"publisher","first-page":"e0174035","DOI":"10.1371\/journal.pone.0174035","volume":"12","author":"HF Golino","year":"2017","unstructured":"Golino, H. F. & Epskamp, S. Exploratory graph analysis: a new approach for estimating the number of dimensions in psychological research. PloS one 12, e0174035 https:\/\/doi.org\/10.1371\/journal.pone.0174035 (2017).","journal-title":"PloS one"},{"key":"799_CR14","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1176\/ajp.154.4.457","volume":"154","author":"GD Tollefson","year":"1997","unstructured":"Tollefson, G. D. et al. 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