Swartz M, Blazer D, Woodbury M, George L, Landerman R
Psychol Med. 1986 Aug;16(3):595-609. doi: 10.1017/s0033291700010357.
The authors examine somatization disorder in a community population, using grade of membership analysis, a new multivariate analytical technique for the analysis of medical classification. The technique is used to examine whether somatic symptoms will cluster into a clinical syndrome resembling somatization disorder, as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), if no a priori assumptions are made about the interrelationship of somatic symptoms or their clustering into clinical syndromes. Grade of membership analysis is applied to all respondents in the US National Institute of Mental Health Epidemiological Catchment Area Project of the Piedmont region of North Carolina reporting three or more somatic symptoms from the somatization disorder section of the Diagnostic Interview Schedule. The analysis indicates that seven 'pure' types, roughly analogous to clusters in cluster analysis, best describe the interrelationship of the symptoms included in the analysis. One 'pure' type in the analysis is nearly identical to DSM-III somatization disorder and is associated with demographic characteristics consistently found among patients with DSM-III somatization disorder. The present results demonstrate that symptoms associated with this disorder do cluster in a highly predictable fashion and represent a strong validation of the natural occurrence of an entity resembling somatization disorder.
作者运用成员等级分析这一用于医学分类分析的新多元分析技术，对社区人群中的躯体化障碍进行了研究。该技术用于检验在不对躯体症状的相互关系或其聚集成临床综合征做任何先验假设的情况下，躯体症状是否会聚集成一种类似于《精神疾病诊断与统计手册》（DSM-III）所定义的躯体化障碍的临床综合征。成员等级分析应用于参与美国国立精神卫生研究所北卡罗来纳州皮埃蒙特地区流行病学集水区项目的所有受访者，这些受访者在诊断访谈表的躯体化障碍部分报告了三种或更多的躯体症状。分析表明，七种“纯”类型，大致类似于聚类分析中的聚类，能最好地描述分析中所包含症状的相互关系。分析中的一种“纯”类型几乎与DSM-III躯体化障碍相同，且与DSM-III躯体化障碍患者中始终存在的人口统计学特征相关。目前的结果表明，与该障碍相关的症状确实以高度可预测的方式聚类，有力地证实了类似躯体化障碍这一实体的自然存在。
