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基于心理健康问题新兵临床症状的潜在类别及其6个月内对治疗的独特临床反应

Latent Classes based on Clinical Symptoms of Military Recruits with Mental Health Issues and Their Distinctive Clinical Responses to Treatment over 6 Months.

作者信息

Park Eun-Hee, Jon Duk-In, Hong Hyun Ju, Jung Myung Hun, Hong Narei

机构信息

Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.

Hallym University Suicide and School Mental Health Institute, Seoul, Korea.

出版信息

Clin Psychopharmacol Neurosci. 2023 Nov 30;21(4):778-786. doi: 10.9758/cpn.23.1061. Epub 2023 May 30.

Abstract

OBJECTIVE

: This study aimed (1) to identify distinct subgroups of psychiatric patients referred for a mental health certificate for military service suitability and (2) to determine whether there is a difference in clinical features such as treatment responsiveness and prognosis among certain subgroups.

METHODS

: We conducted latent profile analysis (LPA) using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) clinical profiles of the participants. Linear mixed model analysis was performed to examine changes in the severity of clinical symptoms and functional level according to the treatment period of the latent classes derived from the LPA.

RESULTS

: The results indicated that the best-fitting model was a three-class model, comprising Class 1 (mild maladjustment), Class 2 (neurotic depression and anxiety), and Class 3 (highly vulnerable and hypervigilant). We demonstrated that the three subgroups displayed different characteristics in treatment responsiveness and clinical course based on their Clinical Global Impression-Severity and Global Assessment of Functioning scores over a treatment period of 6 months. While subjects in Classes 1 and 2 significantly improved over 6 months, those in Class 3 showed little or no improvement in our clinical parameters.

CONCLUSION

: This study has yielded data with clinical implications for treatment planning and interventions for each subgroup classified that were based on MMPI-2 clinical profiles of military recruits who might be maladjusted to serve.

摘要

目的

本研究旨在(1)识别因心理健康状况而被转介以评估是否适合服兵役的精神病患者的不同亚组,以及(2)确定某些亚组在治疗反应性和预后等临床特征方面是否存在差异。

方法

我们使用参与者的明尼苏达多相人格调查表-2(MMPI-2)临床剖面图进行潜在剖面分析(LPA)。进行线性混合模型分析,以根据LPA得出的潜在类别治疗期检查临床症状严重程度和功能水平的变化。

结果

结果表明,最佳拟合模型是一个三类模型,包括第1类(轻度适应不良)、第2类(神经性抑郁和焦虑)和第3类(高度易受伤害和过度警觉)。我们证明,在6个月的治疗期内,这三个亚组根据其临床总体印象-严重程度和功能总体评估得分,在治疗反应性和临床病程方面表现出不同特征。虽然第1类和第2类的受试者在6个月内有显著改善,但第3类的受试者在我们的临床参数上几乎没有改善。

结论

本研究得出的数据对基于可能不适合服役的新兵的MMPI-2临床剖面图而划分的每个亚组的治疗计划和干预措施具有临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8482/10591162/ffcb7295cfa5/cpn-21-4-778-f1.jpg

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