Department of Psychiatry and Health Behavior, Georgia Health Sciences University, 997 Saint Sebastian WayAugusta, GA 30912, USA.
Bipolar Disord. 2011 Aug-Sep;13(5-6):522-36. doi: 10.1111/j.1399-5618.2011.00940.x.
The taxonic versus dimensional status of mood symptoms has been the subject of debate among mental health professionals. Conventional diagnostic models suggest that mood disorders are categorical; however, the inability of categorical models to adequately account for subthreshold unipolar and bipolar presentations and the heterotypic continuity of symptoms in unipolar and bipolar cases has resulted in growing support for dimensional views. The current study sought to evaluate the relative viabilities of categorical and dimensional models of mood symptoms within a taxometric framework.
We examined the latent structure of mood symptoms in an epidemiological sample drawn from the Collaborative Psychiatric Epidemiological Surveys. Using three taxometric procedures (MAMBAC, MAXEIG, and L-Mode), we analyzed indicators of mania and depression created from the mood symptoms section of the survey.
The taxometric analyses supported a taxonic rather than dimensional structure for mania and depression. Membership in the mania and depressive taxa was associated with meeting criteria for DSM-IV lifetime manic episode and major depressive disorder, respectively. We identified a subset of 700 individuals falling into both taxa; membership in this subset was associated with lifetime bipolar disorder status. Group membership predicted designated external variables including help-seeking, family history, and duration of impairment. Within taxon and/or complement groups, severity scores still appeared to predict external variables.
Our findings suggest that although taxonic, mood disorders possess meaningful dimensional variation.
心境症状的分类与维度状态一直是精神卫生专业人员争论的主题。传统的诊断模型表明心境障碍是分类的；然而，分类模型无法充分说明阈下单相和双相表现，以及单相和双相病例症状的异质连续性，这导致了对维度观点的支持日益增加。本研究旨在在分类框架内评估心境症状的分类和维度模型的相对活力。
我们在合作性精神流行病学调查中从流行病学样本中检查了心境症状的潜在结构。使用三种分类程序（MAMBAC、MAXEIG 和 L-Mode），我们分析了从调查的心境症状部分创建的躁狂和抑郁指标。
分类分析支持躁狂和抑郁的分类而不是维度结构。躁狂和抑郁分类的成员资格分别与符合 DSM-IV 终生躁狂发作和重性抑郁障碍的标准相关。我们确定了一个包含这两个分类的 700 人的子集；该子集的成员资格与终生双相情感障碍状况相关。群体成员资格预测了指定的外部变量，包括寻求帮助、家族史和残疾持续时间。在分类和/或补充组内，严重程度评分似乎仍然可以预测外部变量。
我们的发现表明，尽管分类，心境障碍具有有意义的维度变化。
