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Tijdschrift voor Psychiatrie 58 (2016) 1, 38 - 47

Essay

Network clusters of symptoms as elementary syndromes of psychopathology: implications for clinical practice

R. Goekoop, J.G. Goekoop

background In a recent publication we reported the existence of around 11 (to 15) ‘elementary syndromes’ that may combine in various ways, rather like ‘building blocks’, to explain the wide range of psychiatric symptoms. ‘Bridge symptoms’ seem to be responsible both for combining large sets of symptoms into elementary syndromes and for combining the various elementary syndromes to form one globally connected network structure.
aim To discuss the implication of these findings for clinical practice.
method We performed a network analysis of symptom scores.
results Elementary syndromes provide a massive simplification of the description of psychiatric disease. Instead of the more than 300 categories in dsm-5, we now need to consider only a handful of elementary syndromes and personality domains. This modular representation of psychiatric illnesses allows us to make a complete, systematic and efficient assessment of patients and a systematic review of treatment options. Clinicians, patients, managerial staff and insurance companies can verify whether symptom reduction is taking place in the most important domains of psychopathology. Unlike classic multidimensional methods of disease description, network models of psychopathology can be used to explain comorbidity patterns, predict the clinical course of psychopathology and to designate primary targets for therapeutic interventions.
conclusion A network view on psychopathology could significantly improve everyday clinical practice.

keywords bridge symptoms, elementary syndromes, network theory, psychopathology