大量严重精神障碍患者的童年创伤、绝望、抑郁症状和精神疼痛之间的相互作用：网络分析

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders Pub Date : 2025-04-01 DOI:10.1016/j.jad.2025.03.185

Stefano Barlati , Marco Innamorati , Antonio Vita , Gabriele Nibbio , Denise Erbuto , Salvatore Sarubbi , Valeria del Vecchio , Mario Luciano , Gaia Sampogna , Giovanni Abbate-Daga , Claudia Carmassi , Giovanni Castellini , Pasquale De Fazio , Giorgio Di Lorenzo , Marco Di Nicola , Silvia Ferrari , Arianna Goracci , Carla Gramaglia , Giovanni Martinotti , Maria Giulia Nanni , Maurizio Pompili

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引用次数: 0

摘要

精神疼痛是严重精神障碍患者自杀行为的重要危险因素。本研究旨在探讨童年创伤经历、绝望、抑郁症状和精神疼痛之间的相互作用，采用网络分析方法，对生活在社区的大量跨诊断样本进行研究。方法：本研究采用一个联合项目组织的多中心观察性横断面研究收集的数据进行，包括不同的意大利研究和临床环境。考虑到本研究采用的评估工具，在EBICglasso网络分析中纳入了12个不同的变量作为节点。采用自举法评估了边和中心性指数的稳定性，同时考虑了案例下降和节点下降过程。结果共纳入受试者2147人。精神痛苦是复杂关系网络的核心特征，包括创伤经历、绝望和抑郁症状。更详细地说，精神痛苦以及情感和认知抑郁症状（在较小程度上）成为网络中最核心和最具影响力的节点，突出了这些方面之间存在的紧密联系及其在精神障碍患者生活中的重要性。结论：结果证实了精神疼痛作为一种跨诊断特征的重要性，需要对所有患者进行仔细评估和考虑，超出诊断类别，无论自杀风险如何。评估和管理精神疼痛的存在和严重程度应该在临床实践中考虑，从提供显著临床效益的角度来看，以及相关的研究见解。

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The interplay between childhood trauma, hopelessness, depressive symptoms, and mental pain in a large sample of patients with severe mental disorders: A network analysis

Background

Mental pain represents a significant risk factor for suicidal behavior in severe mental disorders. The present study aims to investigate the interplay between childhood traumatic experiences, hopelessness, depressive symptoms and mental pain, using a network analysis approach in a large transdiagnostic sample of participants living in the community.

Methods

The present investigation was conducted using data gathered in a multicentric observational cross-section study organized as a joint project, including different Italian research and clinical settings. Considering the assessment tools adopted in the study, 12 different variables were included as nodes in the EBICglasso network analysis. Stability of the edges and of centrality indices were assessed using bootstrap procedures, considering case-dropping and node-dropping procedures.

Results

A total of 2147 participants were included in the analysis. Mental pain represents a central feature in a complex network of relationships, including traumatic experiences, hopelessness, and depressive symptoms. More in deatail, mental pain and, to a lesser extent, affective and cognitive depressive symptoms emerged as the most central and influential nodes of the network, highlighting the strong link existing between these aspects and their importance in the lives of people with mental disorders.

Conclusions

Results confirm the importance of mental pain as a transdiagnostic feature, requiring careful assessment and consideration in all patients, beyond the diagnostic categories and regardless of suicide risk. Assessing and managing the presence and severity of mental pain should be taken into account in clinical practice, in the perspective of providing significant clinical benefits, as well as relevant research insight.

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来源期刊

Journal of affective disorders 医学-精神病学

CiteScore

10.90

自引率

6.10%

发文量

1319

审稿时长

9.3 weeks

期刊介绍： The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.