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新西兰心理健康调查中精神病样体验的潜在类别分析。

A latent class analysis of psychosis-like experiences in the New Zealand Mental Health Survey.

机构信息

Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.

出版信息

Acta Psychiatr Scand. 2011 Sep;124(3):205-13. doi: 10.1111/j.1600-0447.2011.01707.x. Epub 2011 Apr 16.

Abstract

OBJECTIVE

To describe the underlying structure of psychosis-like experiences in the New Zealand Mental Health Survey.

METHOD

A nationwide survey of household residents aged 16+ years was undertaken (n = 7435), using the Composite International Diagnostic Interview (3.0), including a six question lifetime screener for psychosis. Participants were grouped in three ways: by the number of 'symptoms' (occurring when not dreaming, half-asleep or under the influences of drugs) and by latent classes derived from binary responses (no/yes) or ordinal responses (never/sub-threshold/few times/many times).

RESULTS

Psychosis-like events were not uncommon (7.3%; 95% CIs 6.5-8.1), particularly experiences of visual (5.3%; 95% CIs 4.7-6.0) or auditory hallucinations (2.8%; 95% CIs 2.3-3.3). Both latent class analyses indicated a 'normal' class, a 'hallucinatory class' and a 'psychotic' class. The lifetime probability of anxiety, mood or substance disorders and the lifetime probability of seeking help for mental health problems increased from 'normal' to 'hallucinatory' to 'psychotic' classes and with the 'symptom' count.

CONCLUSION

The presence of sub-threshold events and variation in the number of times a 'symptom' is experienced suggest a psychosis continuum. However, the latent classes labelled 'hallucinatory' and 'psychotic' differ markedly in symptomatology, which suggests some form of discrete clustering.

摘要

目的

描述新西兰心理健康调查中类精神病体验的潜在结构。

方法

对年龄在 16 岁及以上的家庭居民进行了一项全国性调查(n=7435),使用复合国际诊断访谈(3.0),包括一个用于精神病的六问题终身筛查器。参与者分为三组:按“症状”(发生在不做梦、半睡或受药物影响时)的数量分组,或按源自二进制(否/是)或有序(从未/亚阈值/几次/多次)反应的潜在类别分组。

结果

类精神病事件并不罕见(7.3%;95%置信区间 6.5-8.1),特别是视觉(5.3%;95%置信区间 4.7-6.0)或听觉幻觉(2.8%;95%置信区间 2.3-3.3)的经历。两种潜在类别分析都表明存在“正常”类别、“幻觉”类别和“精神病”类别。焦虑、情绪或物质障碍的终身发生率以及寻求心理健康问题帮助的终身发生率从“正常”到“幻觉”再到“精神病”类别增加,同时“症状”的数量也在增加。

结论

亚阈值事件的存在以及经历“症状”次数的变化表明存在精神病连续体。然而,标记为“幻觉”和“精神病”的潜在类别在症状学上有明显差异,这表明存在某种离散聚类。

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