Lewis-Fernández Roberto, Horvitz-Lennon Marcela, Blanco Carlos, Guarnaccia Peter J, Cao Zhun, Alegría Margarita
Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, New York, USA.
J Nerv Ment Dis. 2009 May;197(5):337-47. doi: 10.1097/NMD.0b013e3181a2087e.
In US regional studies, Latinos frequently endorse psychotic symptoms associated with impairment and mental health service use, yet do not meet criteria for psychotic disorder. Using a nationally representative Latino sample (N = 2554), we examined the prevalence of psychotic symptoms, their relationship to psychotic disorder, their correlates, and their relationship to mental health outcomes. In this sample, 9.5% (SE = 0.7) endorsed 1 or more lifetime psychotic symptoms, yet 93% of endorsers did not meet Structured Clinical Interview for DSM-IV criteria for psychotic disorders. Endorsement was associated with physical and emotional distress, particularly lifetime anxiety and current substance use disorder. Acculturation to US society and reliance on spiritual/religious help were also associated with psychotic symptom endorsement. These symptoms have substantial clinical significance, being independently associated with suicidal ideation, mental health-related disability, and outpatient mental health service utilization. Endorsed psychotic symptoms in Latinos may constitute a clinically significant marker of general psychiatric vulnerability rather than a sign of psychotic disorder.
在美国区域研究中，拉丁裔常认可与功能损害及使用心理健康服务相关的精神病性症状，但不符合精神病性障碍的诊断标准。我们使用一个具有全国代表性的拉丁裔样本（N = 2554），研究了精神病性症状的患病率、它们与精神病性障碍的关系、相关因素以及它们与心理健康结局的关系。在这个样本中，9.5%（标准误 = 0.7）认可一种或更多终生精神病性症状，但93%的认可者不符合《精神疾病诊断与统计手册第四版》（DSM-IV）精神病性障碍的结构化临床访谈标准。症状认可与身体和情绪困扰相关，尤其是终生焦虑和当前物质使用障碍。融入美国社会以及依赖精神/宗教帮助也与精神病性症状认可有关。这些症状具有重要的临床意义，独立地与自杀观念、心理健康相关残疾以及门诊心理健康服务利用有关。拉丁裔认可的精神病性症状可能构成一般精神疾病易感性的一个具有临床意义的标志，而非精神病性障碍的迹象。
