Klasa Katarzyna, Sobański Jerzy A, Dembińska Edyta, Citkowska-Kisielewska Anna, Mielimąka Michał, Rutkowski Krzysztof
Faculty of Medicine, Department of Psychotherapy, Jagiellonian University Medical College, Poland.
Heliyon. 2023 Feb 24;9(3):e14078. doi: 10.1016/j.heliyon.2023.e14078. eCollection 2023 Mar.
Psychopathology theory and clinical practice require the most complex knowledge about patients' complaints. In patients seeking for psychotherapy, body-related symptoms often complicate treatment.
This study aimed at examining connections between body-related symptoms, and identification of symptoms which may be responsible for emergency and sustaining of anxiety, somatoform and personality disorders with the use of network analysis.
In our retrospective research we used data from a sample of 4616 patients of the Department of Psychotherapy, University Hospital in Cracow, diagnosed with anxiety, somatoform or personality disorders. We constructed the Triangulated Maximally Filtered Graph (TMFG) networks of 44 somatoform symptoms endorsed in the symptom checklist "O" (SCL-O) and identified the most central symptoms within the network for all patients and in subgroups of women vs. men, older vs. younger, and diagnosed in 1980-2000 vs. 2000-2015. We used bootstrap to determine the accuracy and stability of five networks' parameters: strength, expected influence, eigenvector, bridge strength and hybrid centrality.
The most central symptoms within the overall network, and in six subnetworks were dyspnea and migratory pains. We identified some gender-related differences, but no differences were observed for the age and time of diagnosis.
Self-reported dyspnea and migratory pains are potential important targets for treatment procedures.
精神病理学理论和临床实践需要关于患者主诉的最复杂知识。在寻求心理治疗的患者中，与身体相关的症状常常使治疗复杂化。
本研究旨在通过网络分析来检验与身体相关症状之间的联系，并识别可能导致焦虑、躯体形式障碍和人格障碍的紧急情况及持续存在的症状。
在我们的回顾性研究中，我们使用了来自克拉科夫大学医院心理治疗科4616例被诊断为焦虑、躯体形式或人格障碍患者样本的数据。我们构建了症状清单“O”（SCL - O）中认可的44种躯体形式症状的三角最大化过滤图（TMFG）网络，并确定了所有患者以及女性与男性、年龄较大与较小、1980 - 2000年与2000 - 2015年诊断的亚组中网络内最核心的症状。我们使用自助法来确定五个网络参数的准确性和稳定性：强度、预期影响、特征向量、桥接强度和混合中心性。
总体网络以及六个子网络中最核心的症状是呼吸困难和游走性疼痛。我们发现了一些与性别相关的差异，但在年龄和诊断时间方面未观察到差异。
自我报告的呼吸困难和游走性疼痛是治疗程序的潜在重要靶点。
