Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland.
Novartis Institutes for Biomedical Research, Basel, Switzerland.
Clin Psychol Psychother. 2023 Jan;30(1):119-130. doi: 10.1002/cpp.2782. Epub 2022 Sep 28.
The objective of this study is to scrutinize whether psychopathology symptom networks differ between those with and without lifetime: treatment seeking, treatment and treatment of longer duration.
We created non-exclusive groups of subjects with versus without lifetime treatment seeking, treatment and treatment of mid-long-term duration. We estimated Ising models and carried out network comparison tests (NCTs) to compare (a) overall connectivity and (b) network structure. Furthermore, we examined node strength. We used propensity score matching (PSM) to minimize potential confounding by indication for service use.
Based on data from 9,172 participants, there were no statistically significant differences in overall connectivity and network structure in those with versus without lifetime: treatment seeking (p = .75 and p = .82, respectively), treatment (p = .63 and p = .49, respectively) and treatment of mid-longterm duration (p = .15 and p = .62, respectively). Notably, comparing networks with versus without service use consistently revealed higher node strength in 'obsessions' and 'aggression' and lower node strength in 'elevated mood' in all networks with service use.
Findings suggest that after adjusting for potential confounding by indication for service use, there was no indication of an association in overall connectivity or network structure for lifetime treatment seeking, treatment and treatment of longer duration. However, selected structurally important symptoms differed consistently in all three comparisons. Our findings highlight the potential of network analysis methods to examine treatment mechanisms and outcomes. Specifically, more granular network characteristics on the node level may complement and enrich traditional outcomes in clinical research.
本研究旨在详细检查有或无终生：治疗寻求、治疗和治疗时间较长的患者的精神病理学症状网络是否存在差异。
我们创建了有无终生治疗寻求、治疗和中长程治疗的非排他性受试者分组。我们估计了伊辛模型，并进行了网络比较测试（NCT），以比较（a）整体连通性和（b）网络结构。此外，我们还检查了节点强度。我们使用倾向评分匹配（PSM）来最小化服务使用的潜在混杂因素。
基于 9172 名参与者的数据，在有或无终生：治疗寻求（p=0.75 和 p=0.82）、治疗（p=0.63 和 p=0.49）和中长程治疗（p=0.15 和 p=0.62）的患者中，整体连通性和网络结构均无统计学显著差异。值得注意的是，与无服务使用的网络相比，所有具有服务使用的网络中，“强迫症”和“攻击性”的节点强度更高，而“情绪升高”的节点强度更低。
这些发现表明，在调整了服务使用的潜在混杂因素后，终生治疗寻求、治疗和治疗时间较长的患者的整体连通性或网络结构均无关联迹象。然而，所有三种比较中，结构上重要的症状选择均存在一致性差异。我们的研究结果强调了网络分析方法在检查治疗机制和结果方面的潜力。具体来说，节点层面上更精细的网络特征可能会补充和丰富临床研究中的传统结果。
