Kist J D, Vrijsen J N, Mulders P C R, van Eijndhoven P F P, Tendolkar I, Collard R M
Radboudumc, Department of Psychiatry, Nijmegen, 6525, GA, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, 6525, EN, the Netherlands.
Radboudumc, Department of Psychiatry, Nijmegen, 6525, GA, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, 6525, EN, the Netherlands; Pro Persona Mental Health Care, Depression Expertise Centre, Nijmegen, 6525, DX, the Netherlands.
J Psychiatr Res. 2023 May;161:218-227. doi: 10.1016/j.jpsychires.2023.03.003. Epub 2023 Mar 9.
Heterogeneity and comorbidity in psychiatric disorders are common, however, little is known about the impact on well-being and the role of functional limitations. We aimed to identify transdiagnostic psychiatric symptom profiles and to study their association with well-being and the mediating role of functional limitations in a naturalistic psychiatric patient group.
We used four disorder-specific questionnaires to assess symptom severity within a sample of 448 psychiatric patients with stress-related and/or neurodevelopmental disorders and 101 healthy controls. Using both exploratory and confirmatory factor analyses we identified transdiagnostic symptom profiles, which we entered into a linear regression analysis to assess their association with well-being and the mediating role of functional limitations in this association.
We identified eight transdiagnostic symptom profiles, covering mood, self-image, anxiety, agitation, empathy, non-social interest, hyperactivity and cognitive focus. Mood and self-image showed the strongest association with well-being in both patients and controls, while self-image also showed the highest transdiagnostic value. Functional limitations were significantly associated with well-being and fully mediated the relationship between cognitive focus and well-being.
The participant sample consisted of a naturalistic group of out-patients. While this strengthens the ecological validity and transdiagnostic perspective of this study, the patients with a single neurodevelopmental disorder were underrepresented.
Transdiagnostic symptom profiles are valuable in understanding what reduces well-being in psychiatric populations, thereby opening new avenues for functionally meaningful interventions.
精神疾病中的异质性和共病现象很常见，然而，对于其对幸福感的影响以及功能受限的作用却知之甚少。我们旨在识别跨诊断精神症状谱，并研究它们与幸福感的关联以及功能受限在一个自然状态下的精神疾病患者群体中的中介作用。
我们使用了四份针对特定疾病的问卷，对448名患有应激相关和/或神经发育障碍的精神疾病患者以及101名健康对照者的样本进行症状严重程度评估。通过探索性和验证性因素分析，我们识别出了跨诊断症状谱，并将其纳入线性回归分析，以评估它们与幸福感的关联以及功能受限在这种关联中的中介作用。
我们识别出了八个跨诊断症状谱，涵盖情绪、自我形象、焦虑、激动、同理心、非社交兴趣、多动和认知专注。情绪和自我形象在患者和对照者中与幸福感的关联最强，而自我形象也显示出最高的跨诊断价值。功能受限与幸福感显著相关，并完全中介了认知专注与幸福感之间的关系。
参与者样本由一组自然状态下的门诊患者组成。虽然这增强了本研究的生态效度和跨诊断视角，但单一神经发育障碍的患者代表性不足。
跨诊断症状谱对于理解精神疾病人群中降低幸福感的因素具有重要价值，从而为具有功能意义的干预开辟了新途径。
