精神病超高风险个体的跨诊断症状维度:多能性风险的维度表征

IF 2.2 4区 医学 Q3 PSYCHIATRY
Julia C. C. Schulte-Strathaus, Christian Rauschenberg, Isabell Paetzold, Diego Quattrone, Jessica Hartmann, Paul Amminger, Hok Pan Yuen, Patrick D. McGorry, Barnaby Nelson, Ulrich Reininghaus
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引用次数: 0

摘要

导论研究已将重点从分类转移到心理健康状况的维度概念化。这一点得到了疾病之间高度重叠的支持,特别是精神病谱系和情感障碍,这跨越了传统的诊断界限。虽然有证据表明精神分裂症、分裂情感性障碍和精神病性双相I型障碍患者存在精神病理学的一般因素,但精神病理学的跨诊断维度尚未在精神病超高风险的年轻人中进行调查,即在首次发作精神病之前具有多能症状模式的年轻人。目前的研究试图调查(1)个体的精神病理症状是否存在一般维度,以及(2)特定症状维度(即阳性症状、阴性症状、情感和激活)的形成是否与一般维度相一致。方法对早期精神病分期治疗(STEP)试验中简易精神病学评定量表的症状评分基线进行项目因子分析。结果共纳入342名UHR参与者。与单一和多维模型相比,具有一个一般症状维度和四个特定因素(阳性症状、阴性症状、影响和激活)的双因素模型产生了最佳的相对模型拟合和可解释性,尽管绝对模型拟合统计没有提供强有力的证据来支持这一发现。然而,模型的稳定性和可解释性初步表明,它可以帮助区分多能性和领域特异性症状模式。结论研究结果谨慎地表明,BPRS可能同时反映了一般维度和几个更具体的维度,反映了样本中潜在的多能性心理特征。在这个具有各种合并症的异质性样本中,风险综合征的“共同点”将为支持青年跨诊断表型的概念提供进一步的证据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Transdiagnostic Symptom Dimensions in Individuals at Ultra-High Risk for Psychosis: Towards Dimensional Representations of Pluripotent Risk

Intro

Research has shifted focus from categorical to dimensional conceptualisations of mental health conditions. This is supported by high overlap between disorders, particularly psychosis spectrum and affective disorders, which cuts across traditional diagnostic boundaries. While there is evidence for a general factor of psychopathology in individuals with schizophrenia, schizoaffective disorder, and psychotic bipolar I disorder, transdiagnostic dimensions of psychopathology have not been investigated in young individuals at ultra-high risk for psychosis, that is, youth with pluripotent symptom patterns preceding first-episode psychosis. The current study sought to investigate (1) whether there is a general dimension underlying psychopathological symptoms in individuals and (2) whether the formation of specific symptom dimensions (i.e., positive symptoms, negative symptoms, affect, and activation) is justified alongside a general dimension.

Methods

Item factor analyses were conducted on symptom ratings of the Brief Psychiatric Rating Scale at baseline in the Staged Treatment in Early Psychosis (STEP) trial.

Results

In total, 342 UHR participants were included. A bifactor model with one general symptom dimension and four specific factors (positive symptoms, negative symptoms, affect, and activation) yielded the best relative model fit and interpretability when compared to uni- and multidimensional models, albeit absolute model fit statistics provided no strong evidence to support this finding. However, model stability and interpretability tentatively suggest it can help tell apart pluripotent and domain-specific symptom patterns.

Conclusion

Findings cautiously suggest that the BPRS may index both a general dimension and several more specific dimensions, reflecting pluripotency underlying psychological features in the sample. A ‘common ground’ across the risk syndrome in this heterogeneous sample, with various comorbidities, would lend further evidence to support the notion of a transdiagnostic phenotype in youth.

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来源期刊
Early Intervention in Psychiatry
Early Intervention in Psychiatry 医学-精神病学
CiteScore
4.80
自引率
5.00%
发文量
112
审稿时长
6-12 weeks
期刊介绍: Early Intervention in Psychiatry publishes original research articles and reviews dealing with the early recognition, diagnosis and treatment across the full range of mental and substance use disorders, as well as the underlying epidemiological, biological, psychological and social mechanisms that influence the onset and early course of these disorders. The journal provides comprehensive coverage of early intervention for the full range of psychiatric disorders and mental health problems, including schizophrenia and other psychoses, mood and anxiety disorders, substance use disorders, eating disorders and personality disorders. Papers in any of the following fields are considered: diagnostic issues, psychopathology, clinical epidemiology, biological mechanisms, treatments and other forms of intervention, clinical trials, health services and economic research and mental health policy. Special features are also published, including hypotheses, controversies and snapshots of innovative service models.
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