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计算精神病学中的动力系统:一个理解精神症状动态变化的玩具模型。

Dynamical systems in computational psychiatry: A toy-model to apprehend the dynamics of psychiatric symptoms.

作者信息

Gauld Christophe, Depannemaecker Damien

机构信息

Department of Child Psychiatry, University Hospital Lyon, Lyon, France.

Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS, Université Claude Bernard Lyon 1, Lyon, France.

出版信息

Front Psychol. 2023 Feb 3;14:1099257. doi: 10.3389/fpsyg.2023.1099257. eCollection 2023.

Abstract

INTRODUCTION

These last years, scientific research focuses on the dynamical aspects of psychiatric disorders and their clinical significance. In this article, we proposed a theoretical framework formalized as a generic mathematical model capturing the heterogeneous individual evolutions of psychiatric symptoms. The first goal of this computational model based on differential equations is to illustrate the nonlinear dynamics of psychiatric symptoms. It offers an original approach to nonlinear dynamics to clinical psychiatrists.

METHODS

In this study, we propose a 3+1 dimensions model ( + ) reproducing the clinical observations encountered in clinical psychiatry with: a variable modeling environmental noise () on the patient's internal factors () with its temporal specificities () and symptomatology (). This toy-model is able to integrate empirical or simulated data from the influence of perceived environmental over time, their potential importance on the internal and subjective patient-specific elements, and their interaction with the apparent intensity of symptoms.

RESULTS

Constrained by clinical observation of case formulations, the dynamics of psychiatric symptoms is studied through four main psychiatric conditions were modeled: i) a healthy situation, ii) a kind of psychiatric disorder evolving following an outbreak (i.e., schizophrenia spectrum), iii) a kind of psychiatric disorder evolving by kindling and bursts (e.g., bipolar and related disorders); iv) and a kind of psychiatric disorder evolving due to its high susceptibility to the environment (e.g., spersistent complex bereavement disorder). Moreover, we simulate the action of treatments on different psychiatric conditions.

DISCUSSION

We show that the challenges of dynamical systems allow to understand the interactions of psychiatric symptoms with environmental, descriptive, subjective or biological variables. Although this non-linear dynamical model has limitations (e.g., explanatory scope or discriminant validity), simulations provide at least five main interests for clinical psychiatry, such as a visualization of the potential different evolution of psychiatric disorders, formulation of clinical cases, information about attracting states and bifurcations, or the possibility of a nosological refinement of psychiatric models (e.g., staging and symptom network models).

摘要

引言

近年来,科学研究聚焦于精神疾病的动态方面及其临床意义。在本文中,我们提出了一个理论框架,将其形式化为一个通用数学模型,以捕捉精神症状的异质性个体演变。这个基于微分方程的计算模型的首要目标是阐明精神症状的非线性动力学。它为临床精神科医生提供了一种研究非线性动力学的全新方法。

方法

在本研究中,我们提出了一个3 + 1维模型( + ),该模型再现了临床精神病学中遇到的临床观察结果,其中:一个变量对患者内部因素()上的环境噪声()进行建模,同时考虑其时间特异性()和症状学()。这个简化模型能够整合来自随时间变化的感知环境影响的经验数据或模拟数据、它们对患者特定内部和主观因素的潜在重要性,以及它们与症状表观强度的相互作用。

结果

受病例表述临床观察的约束,通过对四种主要精神疾病状况进行建模来研究精神症状的动力学:i)健康状况,ii)一种爆发后演变的精神疾病(即精神分裂症谱系),iii)一种通过点燃和爆发演变的精神疾病(例如双相情感障碍及相关疾病);iv)一种因其对环境高度敏感而演变的精神疾病(例如持续性复杂丧亲障碍)。此外,我们模拟了不同精神疾病状况下治疗的作用。

讨论

我们表明,动力系统的挑战有助于理解精神症状与环境、描述性、主观或生物学变量之间的相互作用。尽管这个非线性动力学模型存在局限性(例如解释范围或判别效度),但模拟至少为临床精神病学提供了五个主要益处,例如可视化精神疾病潜在的不同演变、临床病例的制定、关于吸引态和分岔的信息,或者精神疾病模型进行疾病分类细化的可能性(例如分期和症状网络模型)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c8c/9945965/11d387303abc/fpsyg-14-1099257-g0001.jpg

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