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一般人群中精神病的潜在结构:来自新加坡心理健康研究的结果。

Latent structure of psychosis in the general population: results from the Singapore mental health study.

机构信息

Research Division, Institute of Mental Health, Buangkok Green Medical Park, Singapore.

出版信息

Psychol Med. 2014 Jan;44(1):51-60. doi: 10.1017/S0033291713000688. Epub 2013 Apr 11.

Abstract

BACKGROUND

Few studies have examined the latent construct of psychotic symptoms or distinguished between the latent construct and its manifest indicators. The current study aimed to investigate the latent structure of psychotic symptoms using factor mixture modeling (FMM) and to use the best-fitting model to examine its sociodemographic and clinical correlates.

METHOD

The Singapore Mental Health Study (SMHS) was based on an adult representative sample of the Singapore population. Psychotic symptoms were assessed by using the Psychosis Screen section of the Composite International Diagnostic Interview version 3.0 (CIDI 3.0). FMM analyses were applied to determine the latent construct of psychotic symptoms. Sociodemographic and clinical correlates of the latent structure of psychosis symptoms were examined using multiple linear and logistic regression analyses.

RESULTS

The overall weighted lifetime prevalence of any psychotic experience was 3.8% in the SMHS after excluding subthreshold experiences. The FMM analysis clearly supported the dimensional model of the latent structure of psychotic symptoms. On deriving the total score for 'psychosis symptoms' in accordance with the one latent trait model, and correlating it with sociodemographic factors, we found that female gender, vocational education, current and past smokers were positively associated with the 'psychosis' total score.

CONCLUSIONS

There is a need for an increased understanding of, and research into, this intermediate state of 'psychosis symptoms' that do not meet diagnostic criteria for psychosis. It is also important to learn more about the group of individuals in the community who may have preserved functioning to elucidate the protective factors that prevent transition to psychosis.

摘要

背景

很少有研究探讨精神病症状的潜在结构,也没有区分潜在结构与其表现指标。本研究旨在使用因子混合建模(FMM)研究精神病症状的潜在结构,并使用最佳拟合模型来研究其社会人口学和临床相关性。

方法

新加坡心理健康研究(SMHS)基于新加坡人口的成人代表性样本。使用复合国际诊断访谈第 3.0 版(CIDI 3.0)的精神病筛选部分评估精神病症状。应用 FMM 分析确定精神病症状的潜在结构。使用多元线性和逻辑回归分析研究精神病症状潜在结构的社会人口学和临床相关性。

结果

在排除亚阈值体验后,SMHS 中任何精神病体验的总体加权终生患病率为 3.8%。FMM 分析清楚地支持精神病症状潜在结构的维度模型。根据一个潜在特质模型得出“精神病症状”的总分,并将其与社会人口学因素相关联,我们发现女性、职业教育、当前和过去的吸烟者与“精神病”总分呈正相关。

结论

需要更多地了解和研究不符合精神病诊断标准的这种“精神病症状”中间状态。了解更多关于社区中可能具有保留功能的个体群体也很重要,以阐明预防向精神病转变的保护因素。

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