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潜在剖面分析通过异常显著性识别出四种不同的精神分裂症临床特征。

Latent profile analysis identifies four different clinical schizophrenia profiles through aberrant salience.

作者信息

Aloi Matteo, de Filippis Renato, Carbone Elvira Anna, Rania Marianna, Bertuca Angela, Golia Marisa, Nicoletta Rosina, Segura-Garcia Cristina, De Fazio Pasquale

机构信息

Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.

Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, 88100, Italy.

出版信息

Schizophrenia (Heidelb). 2024 Oct 18;10(1):93. doi: 10.1038/s41537-024-00514-9.

Abstract

Understanding the role of aberrant salience (AS) in psychosis is crucial for comprehending schizophrenia spectrum disorders (SSDs). Researchers emphasize the importance of salience attribution in schizophrenia, acknowledging its interaction with environmental stressors and multiple neurotransmitter systems. Childhood trauma and adversities (CTA) play a significant role in SSDs, potentially contributing to prodromal symptoms characterized by AS. While empirical evidence supports the relationship between AS and SSD, the interplay between different AS patterns, CTA, and psychotic symptoms remains unclear. Clinical diagnosis followed DSM-5 criteria, and participants completed assessments including the Aberrant Salience Inventory (ASI), Childhood Trauma Questionnaire - Short form (CTQ-SF), and Positive and Negative Symptom Scale (PANSS). Latent profile analysis (LPA) was employed to identify distinct AS profiles within the sample, with subsequent analyses examining differences in psychopathological variables among these profiles. Among 262 participants, four distinct AS profiles emerged from LPA: low AS, high AS with severe symptoms and CTA, intermediate AS with sexual abuse correlation, and chronic AS with specific childhood trauma associations. Profile distinctions included differences in age, hospitalizations, psychotic symptoms, and CTA. Logistic regression analyses showed significant associations between the four profiles and emotional and sexual abuse, physical neglect and clinical variables. Subtyping individuals with SSD based on AS revealed four distinct profiles, each with unique clinical characteristics and associations with CTA. Future studies should investigate whether these profiles correspond to diverse treatment outcomes. These findings highlight the complexity of schizophrenia presentation and underscore the importance of considering individualized diagnostic and therapeutic approaches.

摘要

理解异常突显(AS)在精神病中的作用对于理解精神分裂症谱系障碍(SSD)至关重要。研究人员强调突显归因在精神分裂症中的重要性,承认其与环境应激源和多种神经递质系统的相互作用。童年创伤和逆境(CTA)在SSD中起重要作用,可能导致以AS为特征的前驱症状。虽然实证证据支持AS与SSD之间的关系,但不同AS模式、CTA和精神病症状之间的相互作用仍不清楚。临床诊断遵循DSM-5标准,参与者完成了包括异常突显量表(ASI)、童年创伤问卷简表(CTQ-SF)和阳性与阴性症状量表(PANSS)在内的评估。采用潜在剖面分析(LPA)在样本中识别不同的AS剖面,随后的分析检验这些剖面中心理病理变量的差异。在262名参与者中,LPA出现了四种不同的AS剖面:低AS、伴有严重症状和CTA的高AS、与性虐待相关的中度AS以及与特定童年创伤相关的慢性AS。剖面差异包括年龄、住院次数、精神病症状和CTA的差异。逻辑回归分析显示,这四种剖面与情感和性虐待、身体忽视及临床变量之间存在显著关联。基于AS对SSD个体进行亚型分类揭示了四种不同的剖面,每种剖面都有独特的临床特征以及与CTA的关联。未来的研究应调查这些剖面是否对应不同的治疗结果。这些发现突出了精神分裂症表现的复杂性,并强调了考虑个体化诊断和治疗方法的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30e9/11489417/d5b2091b52f8/41537_2024_514_Fig1_HTML.jpg

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