种族不平等、多种疾病并存与精神病：疾病综合征框架能否解决有争议的证据？
Ethnic inequality, multimorbidity and psychosis: can a syndemic framework resolve disputed evidence?
作者信息
Zahid Uzma, Hosang Georgina M, de Freitas Daniela Fonseca, Mooney Roisin, Bhui Kamaldeep
机构信息
Department of Psychiatry, University of Oxford, Oxford, UK.
Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
出版信息
Schizophrenia (Heidelb). 2023 Jun 9;9(1):37. doi: 10.1038/s41537-023-00367-8.
Abstract
Syndemic theory is described as population-level clustering or co-occurrence of health conditions in the context of shared aetiologies that interact and can act synergistically. These influences appear to act within specific places of high disadvantage. We suggest ethnic inequality in experiences and outcomes of multimorbidity, including psychosis, may be explained through a syndemic framework. We discuss the evidence for each component of syndemic theory in relation to psychosis, using psychosis and diabetes as an exemplar. Following this, we discuss the practical and theoretical adaptations to syndemic theory in order to apply it to psychosis, ethnic inequality and multimorbidity, with implications for research, policy, and practice.
摘要
综合征理论被描述为在相互作用且可能产生协同作用的共同病因背景下，健康状况在人群层面的聚集或同时出现。这些影响似乎在特定的高度不利地区发挥作用。我们认为，包括精神病在内的多重疾病在经历和结果方面的种族不平等，可能可以通过综合征框架来解释。我们以精神病和糖尿病为例，讨论综合征理论各组成部分与精神病相关的证据。在此之后，我们讨论对综合征理论的实际和理论调整，以便将其应用于精神病、种族不平等和多重疾病，探讨其对研究、政策和实践的影响。
相似文献
1
Ethnic inequality, multimorbidity and psychosis: can a syndemic framework resolve disputed evidence?种族不平等、多种疾病并存与精神病：疾病综合征框架能否解决有争议的证据？
Schizophrenia (Heidelb). 2023 Jun 9;9(1):37. doi: 10.1038/s41537-023-00367-8.
2
Ethnic disparities in psychotic experiences explained by area-level syndemic effects.种族差异导致精神体验差异，这种差异可以用区域层面的综合征效应来解释。
Br J Psychiatry. 2020 Oct;217(4):555-561. doi: 10.1192/bjp.2019.203.
3
Understanding psychosis complexity through a syndemic framework: A systematic review.通过综合征框架理解精神病的复杂性：一项系统综述。
Neurosci Biobehav Rev. 2024 Apr;159:105614. doi: 10.1016/j.neubiorev.2024.105614. Epub 2024 Mar 2.
4
COVID-19: A Syndemic Requiring an Integrated Approach for Marginalized Populations.2019冠状病毒病：一种需要针对边缘化人群采取综合应对措施的综合征候群。
Front Public Health. 2021 May 11;9:675280. doi: 10.3389/fpubh.2021.675280. eCollection 2021.
5
Psychosocial Syndemic Risks Surrounding Physical Health Conditions Among Sexual and Gender Minority Individuals.性少数群体个体的身体健康状况所面临的社会心理综合征风险。
LGBT Health. 2019 Nov/Dec;6(8):377-385. doi: 10.1089/lgbt.2019.0025. Epub 2019 Oct 23.
6
Conceptualising comorbidity and multimorbidity in dementia: A scoping review and syndemic framework.痴呆症中共病和多重共病的概念化：一项范围综述和综合征框架
J Multimorb Comorb. 2022 Sep 27;12:26335565221128432. doi: 10.1177/26335565221128432. eCollection 2022 Jan-Dec.
7
The Syndemic Approach in relation to Clinical Practice and Research in Psychiatry.精神病学临床实践与研究中的综合征方法
Consort Psychiatr. 2020 Dec 4;1(2):3-6. doi: 10.17650/2712-7672-2020-1-2-3-6.
8
Family-Level Multimorbidity among Older Adults in India: Looking through a Syndemic Lens.印度老年人家庭层面的多种共病：从综合征角度看。
Int J Environ Res Public Health. 2022 Aug 10;19(16):9850. doi: 10.3390/ijerph19169850.
9
Using syndemic theory to understand food insecurity and diet-related chronic diseases.利用综合征理论理解食物不安全与饮食相关的慢性疾病。
Soc Sci Med. 2022 Feb;295:113124. doi: 10.1016/j.socscimed.2020.113124. Epub 2020 Jun 15.
10
A mixed-methods, population-based study of a syndemic in Soweto, South Africa.一项基于人群的混合方法研究：南非索韦托的综合征流行。
Nat Hum Behav. 2022 Jan;6(1):64-73. doi: 10.1038/s41562-021-01242-1. Epub 2021 Dec 23.
引用本文的文献
1
Testing syndemic models along pathways to psychotic spectrum disorder: implications for population-level preventive interventions.沿着精神病性谱系障碍路径测试共病模式：对人群层面预防性干预的启示
Psychol Med. 2025 Mar 13;55:e85. doi: 10.1017/S0033291725000455.
2
Exploring causal mechanisms of psychosis risk.探索精神病风险的因果机制。
Neurosci Biobehav Rev. 2024 Jul;162:105699. doi: 10.1016/j.neubiorev.2024.105699. Epub 2024 May 6.
3
Experience-based Investigation and Co-design of Psychosis Centred Integrated Care Services for Ethnically Diverse People with Multimorbidity (CoPICS): study protocol.基于经验的以精神病为中心的、针对患有多种疾病的不同种族人群的综合关怀服务的实证调查与共同设计（CoPICS）：研究方案。
BMJ Open. 2024 Feb 28;14(2):e084121. doi: 10.1136/bmjopen-2024-084121.
4
Childhood Adversity Determines the Syndemic Effects of Violence, Substance Misuse, and Sexual Behavior on Psychotic Spectrum Disorder Among Men.童年逆境决定了暴力、药物滥用和性行为对男性精神病谱系障碍的综合影响。
Schizophr Bull. 2024 Apr 30;50(3):684-694. doi: 10.1093/schbul/sbad165.
本文引用的文献
1
Interaction Between Race, Ethnicity, Severe Mental Illness, and Cardiovascular Disease.种族、民族、严重精神疾病与心血管疾病之间的相互作用。
J Am Heart Assoc. 2022 Jun 21;11(12):e025621. doi: 10.1161/JAHA.121.025621. Epub 2022 Jun 14.
2
Do different adverse childhood experiences lead to specific symptoms of psychosis in adulthood? A systematic review of the current literature.不同的不良童年经历是否会导致成年后患特定类型的精神病症状？对当前文献的系统回顾。
Int J Ment Health Nurs. 2022 Aug;31(4):868-887. doi: 10.1111/inm.12992. Epub 2022 Mar 20.
3
Is psychosis a syndemic manifestation of historical and contemporary adversity? Findings from UK Biobank.精神病是否是历史和当代逆境的综合征表现？来自英国生物库的研究结果。
Br J Psychiatry. 2021 Dec;219(6):686-694. doi: 10.1192/bjp.2021.142.
4
Cortisol Levels in Childhood Associated With Emergence of Attenuated Psychotic Symptoms in Early Adulthood.儿童时期的皮质醇水平与成年早期出现的精神病症状减轻有关。
Biol Psychiatry. 2022 Jan 15;91(2):226-235. doi: 10.1016/j.biopsych.2021.08.009. Epub 2021 Aug 19.
5
Understanding the excess psychosis risk in ethnic minorities: the impact of structure and identity.理解少数民族的精神疾病风险过高问题：结构和身份的影响。
Soc Psychiatry Psychiatr Epidemiol. 2021 Nov;56(11):1913-1921. doi: 10.1007/s00127-021-02042-8. Epub 2021 Aug 24.
6
The prevalence of physical multimorbidity among people with non-affective psychotic disorders 10 years after first diagnosis: a matched retrospective cohort study.首发非情感性精神病性障碍 10 年后躯体多病共患的流行率：一项配对回顾性队列研究。
Soc Psychiatry Psychiatr Epidemiol. 2022 Mar;57(3):495-503. doi: 10.1007/s00127-021-02157-y. Epub 2021 Aug 6.
7
Probability of Transition to Psychosis in Individuals at Clinical High Risk: An Updated Meta-analysis.临床高风险个体向精神病转化的概率：一项更新的荟萃分析。
JAMA Psychiatry. 2021 Sep 1;78(9):970-978. doi: 10.1001/jamapsychiatry.2021.0830.
8
Associations between green/blue spaces and mental health across 18 countries.绿地/蓝地与 18 个国家/地区精神健康的关联。
Sci Rep. 2021 Apr 26;11(1):8903. doi: 10.1038/s41598-021-87675-0.
9
The risk of physical multimorbidity in people with psychotic disorders: A systematic review and meta-analysis.精神障碍患者躯体多病共患风险：系统评价和荟萃分析。
J Psychosom Res. 2021 Jan;140:110315. doi: 10.1016/j.jpsychores.2020.110315. Epub 2020 Nov 24.
10
Treating Schizophrenia: Open Conversations and Stronger Relationships Through Psychoeducation and Shared Decision-Making.治疗精神分裂症：通过心理教育和共同决策进行开放对话并建立更紧密的关系。
Front Psychiatry. 2020 Aug 13;11:761. doi: 10.3389/fpsyt.2020.00761. eCollection 2020.
Zotero 插件