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网络方法在理解精神障碍中的应用:陷阱与前景。

Application of network methods for understanding mental disorders: pitfalls and promise.

机构信息

Department of Psychiatry and Psychology,Maastricht University Medical Centre,Maastricht,The Netherlands.

出版信息

Psychol Med. 2017 Dec;47(16):2743-2752. doi: 10.1017/S0033291717001350. Epub 2017 Jun 5.

Abstract

Galvanized with the availability of sophisticated statistical techniques and large datasets, network medicine has emerged as an active area of investigation. Following this trend, network methods have been utilized to understand the interplay between symptoms of mental disorders. This realistic approach that may provide an improved framework into understanding mental conditions and underlying mechanisms is certainly to be welcomed. However, we have noticed that symptom network studies tend to lose sight of the fundamentals, overlook major limitations embedded in study designs, and make inferences that are difficult to justify with current findings. There is concern that disregarding these flaws may halt the progress of the network approach in psychiatry. Therefore, in this paper, we first attempt to identify the pitfalls: (1) a reductionist understanding of medicine and psychiatry, thereby inadvertently reintroducing the dichotomy of medicine (lung cancer) and psychiatry (depression), (2) a shortsighted view of signs and symptoms, (3) overlooking the limitations of available datasets based on scales with embedded latent class structures, (4) overestimating the importance of the current findings beyond what is supported by the study design. By addressing current issues, the hope is to navigate this rapidly growing field to a more methodologically sound and reproducible path that will contribute to our understanding of mental disorders and its underlying mechanisms.

摘要

受到复杂统计技术和大型数据集可用性的推动,网络医学已成为一个活跃的研究领域。顺着这一趋势,网络方法已被用于理解精神障碍症状之间的相互作用。这种现实的方法可能为理解精神状况和潜在机制提供一个改进的框架,当然值得欢迎。然而,我们注意到,症状网络研究往往忽略了基本原理,忽视了研究设计中嵌入的主要局限性,并做出了难以用现有发现证明的推断。有人担心,忽视这些缺陷可能会阻碍精神病学中网络方法的进展。因此,在本文中,我们首先试图找出这些陷阱:(1)对医学和精神病学的还原论理解,从而无意中重新引入医学(肺癌)和精神病学(抑郁症)的二分法;(2)对症状的短视看法;(3)忽视基于具有嵌入式潜在类别结构的量表的现有数据集的局限性;(4)高估当前发现的重要性超出研究设计的支持范围。通过解决当前的问题,希望能引导这个快速发展的领域走上一条更具方法论和可重复性的道路,为我们理解精神障碍及其潜在机制做出贡献。

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