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使用社会人口统计学和临床聚类分析研究赌博障碍的表型:一种未识别的新亚型?

Phenotypes in Gambling Disorder Using Sociodemographic and Clinical Clustering Analysis: An Unidentified New Subtype?

作者信息

Jiménez-Murcia Susana, Granero Roser, Fernández-Aranda Fernando, Stinchfield Randy, Tremblay Joel, Steward Trevor, Mestre-Bach Gemma, Lozano-Madrid María, Mena-Moreno Teresa, Mallorquí-Bagué Núria, Perales José C, Navas Juan F, Soriano-Mas Carles, Aymamí Neus, Gómez-Peña Mónica, Agüera Zaida, Del Pino-Gutiérrez Amparo, Martín-Romera Virginia, Menchón José M

机构信息

Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.

Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos III, Barcelona, Spain.

出版信息

Front Psychiatry. 2019 Mar 29;10:173. doi: 10.3389/fpsyt.2019.00173. eCollection 2019.

Abstract

Gambling disorder (GD) is a heterogeneous disorder which has clinical manifestations that vary according to variables in each individual. Considering the importance of the application of specific therapeutic interventions, it is essential to obtain clinical classifications based on differentiated phenotypes for patients diagnosed with GD. To identify gambling profiles in a large clinical sample of = 2,570 patients seeking treatment for GD. An agglomerative hierarchical clustering method defining a combination of the Schwarz Bayesian Information Criterion and log-likelihood was used, considering a large set of variables including sociodemographic, gambling, psychopathological, and personality measures as indicators. Three-mutually-exclusive groups were obtained. Cluster 1 ( = 908 participants, 35.5%), labeled as "high emotional distress," included the oldest patients with the longest illness duration, the highest GD severity, and the most severe levels of psychopathology. Cluster 2 ( = 1,555, 60.5%), labeled as "mild emotional distress," included patients with the lowest levels of GD severity and the lowest levels of psychopathology. Cluster 3 ( = 107, 4.2%), labeled as "moderate emotional distress," included the youngest patients with the shortest illness duration, the highest level of education and moderate levels of psychopathology. In this study, the general psychopathological state obtained the highest importance for clustering.

摘要

赌博障碍(GD)是一种异质性疾病,其临床表现因个体变量而异。考虑到应用特定治疗干预措施的重要性,对于诊断为GD的患者,基于不同表型获得临床分类至关重要。为了在2570名寻求GD治疗的患者的大型临床样本中识别赌博特征。使用了一种凝聚层次聚类方法,该方法定义了施瓦茨贝叶斯信息准则和对数似然的组合,考虑了包括社会人口统计学、赌博、精神病理学和人格测量在内的大量变量作为指标。得到了三个相互排斥的组。第1组(908名参与者,35.5%),标记为“高情绪困扰”,包括病程最长、GD严重程度最高和精神病理学水平最严重的老年患者。第2组(1555名,60.5%),标记为“轻度情绪困扰”,包括GD严重程度最低和精神病理学水平最低的患者。第3组(107名,4.2%),标记为“中度情绪困扰”,包括病程最短、教育水平最高和精神病理学水平中等的年轻患者。在这项研究中,一般精神病理状态在聚类中获得了最高的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb29/6450083/78a8a34b1b64/fpsyt-10-00173-g0001.jpg

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