van de Pavert Iris, Sunderland Matthew, Luijten Maartje, Slade Tim, Teesson Maree
Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, 2052, Australia.
Soc Psychiatry Psychiatr Epidemiol. 2017 Oct;52(10):1257-1265. doi: 10.1007/s00127-017-1422-9. Epub 2017 Jul 25.
Studies have consistently demonstrated a reciprocal relationship between internalizing disorders and several chronic physical health conditions. Yet, much of the extant literature fails to take into account the role of comorbidity among internalizing disorders when examining the relationship with poor physical health. The current study applied latent variable modelling to investigate the shared and specific relationships between internalizing (fear and distress factors) and a range of physical health conditions. Data comprised 8841 respondents aged 16-85 years who took part in the 2007 Australian National Survey of Mental Health and Wellbeing. Multiple indicator, multiple causes models were used to parse the shared and specific relationships between internalizing disorders and variables associated with poor physical health. The study found that several physical conditions were significantly related to mean levels of fear and distress. The results were broadly similar but minor differences emerged depending on whether lifetime or past 12 months indicators of mental disorders and physical conditions were utilized in the model. Finally, the results demonstrated that the association between individual mental disorders and physical health conditions are better accounted for by indirect relationships with broad transdiagnostic dimensions rather than including additional disorder-specific relationships. The results indicate that researchers should focus on common mechanisms across multiple internalizing disorders and poor physical health when developing prevention and treatment initiatives.
研究一直表明，内化性障碍与几种慢性身体健康状况之间存在相互关系。然而，现有文献中的大部分在研究与身体健康不佳的关系时，并未考虑内化性障碍中共病的作用。当前的研究应用潜在变量建模来调查内化性（恐惧和痛苦因素）与一系列身体健康状况之间的共同关系和特定关系。数据包括8841名年龄在16至85岁之间的受访者，他们参与了2007年澳大利亚全国心理健康和幸福调查。使用多指标、多原因模型来剖析内化性障碍与身体健康不佳相关变量之间的共同关系和特定关系。研究发现，几种身体状况与恐惧和痛苦的平均水平显著相关。结果大致相似，但根据模型中使用的是精神障碍和身体状况的终生指标还是过去12个月的指标，会出现一些细微差异。最后，结果表明，个体精神障碍与身体健康状况之间的关联，通过与广泛的跨诊断维度的间接关系来解释，比纳入额外的特定障碍关系能更好地说明。结果表明，研究人员在制定预防和治疗措施时，应关注多种内化性障碍和身体健康不佳的共同机制。
