Al-Asadi Ali M, Klein Britt, Meyer Denny
School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia.
J Med Internet Res. 2015 Feb 26;17(2):e55. doi: 10.2196/jmir.4143.
While research in the area of e-mental health has received considerable attention over the last decade, there are still many areas that have not been addressed. One such area is the comorbidity of psychological disorders in a Web-based sample using online assessment and diagnostic tools, and the relationships between comorbidities and psychosocial variables.
We aimed to identify comorbidities of psychological disorders of an online sample using an online diagnostic tool. Based on diagnoses made by an automated online assessment and diagnostic system administered to a large group of online participants, multiple comorbidities (co-occurrences) of 21 psychological disorders for males and females were identified. We examined the relationships between dyadic comorbidities of anxiety and depressive disorders and the psychosocial variables sex, age, suicidal ideation, social support, and quality of life.
An online complex algorithm based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision, was used to assign primary and secondary diagnoses of 21 psychological disorders to 12,665 online participants. The frequency of co-occurrences of psychological disorders for males and females were calculated for all disorders. A series of hierarchical loglinear analyses were performed to examine the relationships between the dyadic comorbidities of depression and various anxiety disorders and the variables suicidal ideation, social support, quality of life, sex, and age.
A 21-by-21 frequency of co-occurrences of psychological disorders matrix revealed the presence of multiple significant dyadic comorbidities for males and females. Also, for those with some of the dyadic depression and the anxiety disorders, the odds for having suicidal ideation, reporting inadequate social support, and poorer quality of life increased for those with two-disorder comorbidity than for those with only one of the same two disorders.
Comorbidities of several psychological disorders using an online assessment tool within a Web-based population were similar to those found in face-to-face clinics using traditional assessment tools. Results provided support for the transdiagnostic approaches and confirmed the positive relationship between comorbidity and suicidal ideation, the negative relationship between comorbidity and social support, and the negative relationship comorbidity and quality of life.
Australian and New Zealand Clinical Trials Registry ACTRN121611000704998; http://www.anzctr.org.au/trial_view.aspx?ID=336143 (Archived by WebCite at http://www.webcitation.org/618r3wvOG).
虽然在过去十年中，电子心理健康领域的研究受到了广泛关注，但仍有许多领域未得到解决。其中一个领域是使用在线评估和诊断工具的基于网络的样本中心理障碍的共病情况，以及共病与心理社会变量之间的关系。
我们旨在使用在线诊断工具识别在线样本中心理障碍的共病情况。基于对大量在线参与者进行的自动化在线评估和诊断系统所做出的诊断，确定了男性和女性21种心理障碍的多种共病（同时出现）情况。我们研究了焦虑症和抑郁症的二元共病与心理社会变量性别、年龄、自杀意念、社会支持和生活质量之间的关系。
使用基于《精神疾病诊断与统计手册》第4版修订本标准的在线复杂算法，为12665名在线参与者分配21种心理障碍的主次诊断。计算了所有障碍中男性和女性心理障碍共现的频率。进行了一系列分层对数线性分析，以研究抑郁症和各种焦虑症的二元共病与自杀意念、社会支持、生活质量、性别和年龄等变量之间的关系。
一个21×21的心理障碍共现频率矩阵显示，男性和女性都存在多种显著的二元共病情况。此外，对于患有某些二元抑郁症和焦虑症的人来说，与仅患有这两种疾病之一的人相比，患有两种疾病共病的人出现自杀意念、报告社会支持不足和生活质量较差的几率更高。
在基于网络的人群中使用在线评估工具得出的几种心理障碍的共病情况，与在面对面诊所中使用传统评估工具得出的情况相似。研究结果为跨诊断方法提供了支持，并证实了共病与自杀意念之间的正相关关系、共病与社会支持之间的负相关关系以及共病与生活质量之间的负相关关系。
澳大利亚和新西兰临床试验注册中心ACTRN121611000704998；http://www.anzctr.org.au/trial_view.aspx?ID=336143（由WebCite存档于http://www.webcitation.org/618r3wvOG）。
