1Bologna Transcultural Psychiatric Team (BoTPT), Department of Medical and Surgical Sciences, University of Bologna, Italy.
Int J Soc Psychiatry. 2014 May;60(3):243-53. doi: 10.1177/0020764013484237. Epub 2013 Jun 2.
Literature on mental disorders in migrants is constantly increasing. Only a few studies describe psychopathological dimensions in migrants over their nosographic diagnoses; however, there is a growing literature about the greater utility of a categorical-dimensional approach, rather than a solely categorical approach, in the understanding of mental disorders. The aim of this paper is to describe the phenomenology of mental disorders in migrants referred to the Transcultural Psychiatric Team of Bologna (BoTPT), by analysing the psychopathological dimensions that underlie their clinical diagnoses.
We recruited all migrants who attended the BoTPT between May 1999 and July 2009. The psychopathological assessment was conducted with the Association for Methodology and Documentation in Psychiatry (AMDP) and clinical diagnoses were formulated according to ICD-10. We proceeded through a two-step analysis: (1) comparing the prevalence rates of psychopathological symptoms across diagnoses; then (2) conducting a factor analysis to assess how those symptoms configure psychopathological dimensions and how these dimensions underlie clinical diagnoses.
As expected, we found significant associations between diagnoses and the prevalence of their core psychopathological symptoms. Factor analysis revealed a strong polymorphism of the psychopathological presentation of mental disorders and unexpectedly showed that in each diagnostic cluster, the first extracted factor was not composed of core symptoms.
A mixed categorical-dimensional approach seems to improve the description of the psychopathology among migrants, as it adds relevant information regarding psychopathological dimensions useful to the understanding of the peculiar clinical expressivity of our patients.
有关移民精神障碍的文献不断增加。只有少数研究描述了移民的精神病理维度，而不是他们的疾病诊断；然而，越来越多的文献认为，在理解精神障碍方面，分类-维度方法比单纯的分类方法更有用。本文的目的是通过分析构成其临床诊断基础的精神病理维度，描述转诊到博洛尼亚跨文化精神病学团队（BoTPT）的移民的精神障碍表现。
我们招募了 1999 年 5 月至 2009 年 7 月期间到 BoTPT 就诊的所有移民。使用精神医学协会的方法和文献学（AMDP）进行精神病理评估，根据 ICD-10 制定临床诊断。我们通过两步分析进行：（1）比较不同诊断中精神病理症状的患病率；然后（2）进行因子分析，以评估这些症状如何构成精神病理维度以及这些维度如何构成临床诊断。
正如预期的那样，我们发现诊断与核心精神病理症状的患病率之间存在显著关联。因子分析显示精神障碍的精神病理表现具有很强的多态性，出人意料的是，在每个诊断群中，第一个提取的因子不是由核心症状组成的。
混合分类-维度方法似乎可以改善对移民精神病理学的描述，因为它增加了有关精神病理维度的相关信息，这对理解我们患者的特殊临床表达很有用。
