美国青少年的情绪和焦虑状况与身体状况存在差异关联。
Mood and anxiety profiles differentially associate with physical conditions in US adolescents.
机构信息
Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA.
Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA; Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.
出版信息
J Affect Disord. 2022 Feb 15;299:22-30. doi: 10.1016/j.jad.2021.11.056. Epub 2021 Nov 24.
BACKGROUND
Mood and anxiety are widely associated with physical conditions, but research and treatment are complicated by their overlap, clinical heterogeneity, and manifestation on a spectrum rather than as discrete disorders. In contrast to previous work relying on threshold-level disorders, we examined the association between empirically-derived profiles of mood and anxiety syndromes with physical conditions in a nationally-representative sample of US adolescents.
METHODS
Participants were 2,911 adolescents (aged 13-18) from the National Comorbidity Survey-Adolescent Supplement who provided information on physical conditions and reported at least one lifetime mood-anxiety 'syndrome' based on direct interviews with the Composite International Diagnostic Interview Version 3.0. Mood-anxiety syndromes reflected 3-level ratings from subthreshold to severe distress/impairment, and subtyped mood episodes. Stepwise latent profile analysis identified mood-anxiety profiles and tested associations with physical conditions.
RESULTS
Three mood-anxiety profiles were identified: "Mood-GAD" (25.6%)-non-atypical depression, mania, generalized anxiety; "Atypical-Panic" (11.3%)-atypical depression, panic; and "Reference" (63.1%)-lower mood and anxiety except specific phobia. Headaches were more prevalent in Mood-GAD and Atypical-Panic than Reference (47.9%, 50.1%, and 37.7%, respectively; p=0.011). Heart problems were more common in Mood-GAD than Atypical-Panic (7.4% v 2.2%, p=0.004) and Reference, with back/neck pain more prevalent in Mood-GAD than Reference (22.5% v 15.3%, p=0.016).
LIMITATIONS
Broad categories of physical conditions without information on specific diagnoses; replication regarding specificity is recommended.
CONCLUSIONS
Heart problems and pain-related conditions were differentially associated with specific mood-anxiety profiles. Subtyping depression and anxiety-inclusive of subthreshold syndromes-and their patterns of clustering may facilitate etiologic and intervention work in multimorbidity.
背景
情绪和焦虑与身体状况广泛相关，但由于它们的重叠、临床异质性以及表现在谱上而不是离散障碍，研究和治疗变得复杂。与以前依赖于阈值障碍的工作不同，我们在具有全国代表性的美国青少年样本中，检查了经验衍生的情绪和焦虑综合征与身体状况之间的关联。
方法
参与者是来自国家共病调查-青少年补充调查的 2911 名青少年（年龄在 13-18 岁之间），他们提供了身体状况信息，并根据与复合国际诊断访谈第 3.0 版的直接访谈报告了至少一种终身情绪-焦虑“综合征”。情绪-焦虑综合征反映了从阈下到严重痛苦/损伤的 3 级评分，以及亚类型的情绪发作。逐步潜在剖面分析确定了情绪-焦虑剖面，并测试了与身体状况的关联。
结果
确定了三种情绪-焦虑剖面：“情绪-GAD”（25.6%）-非典型抑郁、躁狂、广泛性焦虑；“非典型惊恐”（11.3%）-非典型抑郁、惊恐；以及“参考”（63.1%）-情绪和焦虑较低，除了特定恐惧症。头痛在情绪-GAD 和非典型惊恐中比参考更常见（分别为 47.9%、50.1%和 37.7%；p=0.011）。情绪-GAD 中比非典型惊恐（7.4%比 2.2%；p=0.004）和参考中更常见心脏问题，情绪-GAD 中比参考中更常见背痛/颈痛（22.5%比 15.3%；p=0.016）。
局限性
身体状况的广泛类别，没有具体诊断信息；建议进行特异性复制。
结论
心脏问题和与疼痛相关的状况与特定的情绪-焦虑剖面有不同的关联。对抑郁和焦虑进行亚型分类，包括阈下综合征，并对其聚类模式进行分类，可能有助于在多种疾病中进行病因和干预工作。
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