Domínguez-Martínez Tecelli, Sheinbaum Tamara, Fresán Ana, Nieto Lourdes, López Steven R, Robles Rebeca, Lara Ma Del Carmen, de la Fuente-Sandoval Camilo, Barrantes-Vidal Neus, Saracco Ricardo, Franco-Paredes Karina, Díaz-Reséndiz Felipe, Rosel Mauricio
Centro de Investigación en Salud Mental Global, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz"-UNAM, Mexico City, Mexico.
Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz", Mexico City, Mexico.
Front Psychiatry. 2023 Feb 16;14:1095222. doi: 10.3389/fpsyt.2023.1095222. eCollection 2023.
Epidemiological evidence has linked an array of sociodemographic and psychosocial factors with an increased risk of developing psychosis. However, research in samples from low- and middle-income countries is still scarce. This study used a Mexican sample to explore (i) sociodemographic and psychosocial differences between individuals with and without a positive screen for Clinical High-Risk for psychosis (CHR), and (ii) sociodemographic and psychosocial factors associated with screening positive for CHR. The sample consisted of 822 individuals from the general population who completed an online survey. Of the participants, 17.3% ( = 142) met the CHR screening criteria. Comparisons between those who screened positive (CHR-positive group) and those who did not (Non-CHR group) showed that participants in the CHR-positive group were younger, had a lower educational level, and reported more mental health problems than the Non-CHR group. Furthermore, relative to the Non-CHR group, the CHR-positive group had a greater prevalence of medium/high risk associated with cannabis use, a higher prevalence of adverse experiences (bullying, intimate partner violence, and experiencing a violent or unexpected death of a relative or friend), as well as higher levels of childhood maltreatment, poorer family functioning, and more distress associated with the COVID-19 pandemic. Groups did not differ in sex, marital/relationship status, occupation, and socio-economic status. Finally, when examined in multivariate analyses, the variables associated with screening positive for CHR were: having an unhealthy family functioning (OR = 2.75, 95%CI 1.69-4.46), a higher risk associated with cannabis use (OR = 2.75, 95%CI 1.63-4.64), a lower level of education (OR = 1.55, 95%CI 1.003-2.54), having experienced a major natural disaster (OR = 1.94, 95%CI 1.18-3.16), having experienced a violent or unexpected death of a relative or friend (OR = 1.85, 95%CI 1.22-2.81), higher levels of childhood emotional abuse (OR = 1.88, 95%CI 1.09-3.25), physical neglect (OR = 1.68, 95%CI 1.08-2.61), and physical abuse (OR = 1.66, 95%CI 1.05-2.61), and higher COVID-related distress (OR = 1.10, 95%CI 1.01-1.20). An older age was a protective factor for screening positive for CHR (OR = 0.96, 95%CI 0.92-0.99). Overall, the findings highlight the importance of examining potential psychosocial contributors to psychosis vulnerability across different sociocultural contexts to delineate risk and protective processes relevant to specific populations and better target preventive intervention efforts.
流行病学证据表明,一系列社会人口学和心理社会因素与患精神病风险增加有关。然而,来自低收入和中等收入国家样本的研究仍然很少。本研究以墨西哥样本为对象,探讨:(i)精神病临床高危(CHR)筛查呈阳性和未呈阳性的个体之间的社会人口学和心理社会差异;(ii)与CHR筛查呈阳性相关的社会人口学和心理社会因素。样本包括822名来自普通人群并完成在线调查的个体。参与者中,17.3%(n = 142)符合CHR筛查标准。筛查呈阳性者(CHR阳性组)与未呈阳性者(非CHR组)的比较表明,CHR阳性组的参与者比非CHR组更年轻,受教育程度更低,报告的心理健康问题更多。此外,相对于非CHR组,CHR阳性组中与大麻使用相关的中/高风险患病率更高,不良经历(欺凌、亲密伴侣暴力以及经历亲戚或朋友的暴力或意外死亡)的患病率更高,童年虐待水平更高,家庭功能更差,以及与新冠疫情相关的痛苦更多。两组在性别、婚姻/关系状况、职业和社会经济地位方面没有差异。最后,在多变量分析中,与CHR筛查呈阳性相关的变量有:家庭功能不健康(OR = 2.75,95%CI 1.69 - 4.46)、与大麻使用相关的风险更高(OR = 2.75,95%CI 1.63 - 4.64)、教育水平较低(OR = 1.55,95%CI 1.003 - 2.54)、经历过重大自然灾害(OR = 1.94,95%CI 1.18 - 3.16)、经历过亲戚或朋友的暴力或意外死亡(OR = 1.85,95%CI 1.22 - 2.81)、童年情感虐待水平较高(OR = 1.88,95%CI 1.09 - 3.25)、身体忽视(OR = 1.68,95%CI 1.08 - 2.61)和身体虐待(OR = 1.66,95%CI 1.05 - 2.61),以及与新冠相关的痛苦更高(OR = 1.10,95%CI 1.01 - 1.20)。年龄较大是CHR筛查呈阳性的保护因素(OR = 0.96,95%CI 0.92 - 0.99)。总体而言,研究结果凸显了在不同社会文化背景下检查精神病易感性潜在心理社会因素的重要性,以确定与特定人群相关的风险和保护过程,并更好地针对预防性干预措施。