Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; United States Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, 950 Campbell Avenue 151E, West Haven, CT, USA.
J Psychiatr Res. 2013 Nov;47(11):1649-57. doi: 10.1016/j.jpsychires.2013.07.028. Epub 2013 Aug 23.
Latent class analysis (LCA) offers a parsimonious way of classifying common typologies of psychiatric comorbidity. We used LCA to identify the nature and correlates of predominant typologies of Axis I and II disorders in a large and comprehensive population-based sample of U.S. adults.
We analyzed data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (2004-2005; n = 34,653), a population-based sample of U.S. adults. We derived latent classes based on all assessed Axis I and II disorders and examined the relationship between the identified Axis I classes and lifetime psychiatric disorders and suicide attempts, and physical and mental health-related quality of life.
A four-class solution was optimal in characterizing predominant typologies of both Axis I and II disorders. For Axis I disorders, these included low psychopathology (n = 28,935, 84.0%), internalizing (n = 3693, 9.9%), externalizing (n = 1426, 4.5%), and high psychopathology (n = 599, 1.6%) classes. For Axis II disorders, these included no/low personality disorders (n = 31,265, 90.9%), obsessive/paranoid (n = 1635, 4.6%), borderline/dysregulated (n = 1319, 3.4%), and highly comorbid (n = 434, 1.1%) classes. Compared to the low psychopathology class, all other Axis I classes had significantly increased odds of mental disorders, elevated Axis II classes, suicide attempts and poorer quality of life, with the high psychopathology class having the overall highest rates of these correlates, with the exception of substance use disorders. Compared to the low psychopathology class, the internalizing and externalizing classes had increased rates of mood and anxiety disorders, and substance use disorders, respectively.
Axis I and II psychopathology among U.S. adults may be best represented by four predominant typologies. Characterizing co-occurring patterns of psychopathology using person-based typologies represents a higher-order classification system that may be useful in clinical and research settings.
潜在类别分析（LCA）提供了一种简洁的方法来对常见的精神共病类型进行分类。我们使用 LCA 来确定美国成年人的大型综合人群样本中主要的轴 I 和轴 II 障碍的性质和相关性。
我们分析了全国酒精相关条件流行病学调查（2004-2005 年；n = 34653）的第 2 波数据，这是一个基于人群的美国成年人样本。我们根据所有评估的轴 I 和 II 障碍得出潜在类别，并检查所确定的轴 I 类别与终身精神障碍和自杀企图以及身体和心理健康相关生活质量之间的关系。
一个四类别解决方案是描述轴 I 和 II 障碍的主要类型的最佳选择。对于轴 I 障碍，这些包括低精神病理学（n = 28935，84.0%）、内化（n = 3693，9.9%）、外化（n = 1426，4.5%）和高精神病理学（n = 599，1.6%）。对于轴 II 障碍，这些包括无/低人格障碍（n = 31265，90.9%）、强迫/偏执（n = 1635，4.6%）、边缘/失调（n = 1319，3.4%）和高度共病（n = 434，1.1%）。与低精神病理学类别相比，所有其他轴 I 类别均具有更高的精神障碍、升高的轴 II 类别、自杀企图和较差的生活质量的可能性，高精神病理学类别除了物质使用障碍外，具有这些相关性的总体最高发生率。与低精神病理学类别相比，内化和外化类别分别具有更高的心境和焦虑障碍以及物质使用障碍的发生率。
美国成年人的轴 I 和轴 II 病理可能最好由四种主要类型来表示。使用基于个体的类型学来描述共病模式的共病模式代表了一种更高阶的分类系统，在临床和研究环境中可能是有用的。
