Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center.
Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center; Research Service, Tennessee Valley HealthCare System, US Department of Veterans Affairs.
J Affect Disord. 2020 Sep 1;274:995-1003. doi: 10.1016/j.jad.2020.05.119. Epub 2020 May 23.
The conceptualization of risk for psychiatric illness is moving from risk factors for specific psychiatric disorders to factors that confer risk for multiple disorders. One potential transdiagnostic risk factor is inhibited temperament, a trait characterized by a fearful or avoidant response to novelty. Inhibited temperament is an established risk factor for anxiety disorders, and evidence suggests inhibited temperament is elevated in schizophrenia, bipolar disorder, and major depressive disorder.
In the current study, we tested the hypothesis that inhibited temperament is a transdiagnostic factor in 490 participants including individuals with schizophrenia (n=184), psychotic bipolar disorder (n=61), major depression disorder (n=53), or no disorders (n=192). Participants completed assessments of temperament, personality, clinical symptoms, cognition, and functioning. An ANOVA was used to test for group differences in inhibited temperament scores. Regressions were used to test whether inhibited temperament scores were associated with the current measures and whether the associations were similar across disorders.
Inhibited temperament was similarly elevated in all patient groups compared to controls. Inhibited temperament was similarly associated with anxiety, depression, negative affect, and quality of life across patient groups. Inhibited temperament was not associated with cognition or functional impairment.
Although the inhibited temperament measure is commonly used, it is a retrospective self-report which may be susceptible to biases.
The current study provides evidence that inhibited temperament is a transdiagnostic factor impacting affective systems across mood and psychotic disorders. Inhibited patients may especially benefit from treatments that specifically target anxiety and depression.
精神疾病风险的概念正在从特定精神障碍的风险因素转变为多种障碍的风险因素。一个潜在的跨诊断风险因素是抑制气质,其特征是对新奇事物的恐惧或回避反应。抑制气质是焦虑障碍的既定风险因素,有证据表明,在精神分裂症、双相情感障碍和重度抑郁症中,抑制气质水平升高。
在当前研究中,我们测试了抑制气质是包括精神分裂症(n=184)、精神病性双相情感障碍(n=61)、重度抑郁症(n=53)或无障碍(n=192)在内的 490 名参与者的跨诊断因素的假设。参与者完成了气质、人格、临床症状、认知和功能的评估。方差分析用于检验不同组之间的抑制气质评分差异。回归用于检验抑制气质评分是否与当前的测量值相关,以及这些关联是否在不同的障碍中相似。
与对照组相比,所有患者组的抑制气质评分均升高。在患者组中,抑制气质评分与焦虑、抑郁、负性情绪和生活质量相似相关。抑制气质评分与认知或功能障碍无关。
尽管抑制气质测量被广泛使用,但它是一种回顾性的自我报告,可能容易受到偏见的影响。
本研究提供了证据表明,抑制气质是影响情感系统的跨诊断因素,跨越了心境和精神病性障碍。抑制患者可能特别受益于专门针对焦虑和抑郁的治疗。