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情感性和非情感性精神障碍中临床医生评定症状的跨诊断模型构建

Transdiagnostic modeling of clinician-rated symptoms in affective and nonaffective psychotic disorders.

作者信息

Chung Yoonho, Girard Jeffrey M, Ravichandran Caitlin, Öngür Dost, Cohen Bruce M, Baker Justin T

机构信息

Department of Psychiatry, Harvard Medical School.

Department of Psychology, University of Kansas.

出版信息

J Psychopathol Clin Sci. 2025 Jan;134(1):81-96. doi: 10.1037/abn0000958. Epub 2024 Oct 24.

Abstract

Prevailing factor models of psychosis are centered on schizophrenia-related disorders defined by the and , restricting generalizability to other clinical presentations featuring psychosis, even though affective psychoses are more common. This study aims to bridge this gap by conducting exploratory and confirmatory factor analyses, utilizing clinical ratings collected from patients with either affective or nonaffective psychoses ( = 1,042). Drawing from established clinical instruments, such as the Positive and Negative Syndrome Scale, Young Mania Rating Scale, and Montgomery-Åsberg Depression Rating Scale, a broad spectrum of core psychotic symptoms was considered for the model development. Among the candidate models considered, including correlated factors and multifactor models, a model with seven correlated factors encompassing positive symptoms, negative symptoms, depression, mania, disorganization, hostility, and anxiety was most interpretable with acceptable fit. The seven factors exhibited expected associations with external validators, were replicable through cross-validation, and were generalizable across affective and nonaffective psychoses. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

摘要

当前的精神病因素模型主要围绕由[具体标准1]和[具体标准2]定义的精神分裂症相关障碍展开,即便情感性精神病更为常见,其可推广性仍局限于以精神病为特征的其他临床表现。本研究旨在通过进行探索性和验证性因素分析来弥合这一差距,分析时利用从情感性或非情感性精神病患者(n = 1042)收集的临床评分。借鉴如阳性和阴性症状量表、杨氏躁狂评定量表以及蒙哥马利-阿斯伯格抑郁评定量表等既定临床工具,模型构建考虑了广泛的核心精神病症状。在考虑的候选模型中,包括相关因素模型和多因素模型,一个包含阳性症状、阴性症状、抑郁、躁狂、紊乱、敌意和焦虑的七因素相关模型具有可接受的拟合度且最具解释力。这七个因素与外部验证指标呈现出预期的关联,可通过交叉验证进行复制,并且在情感性和非情感性精神病中具有可推广性。(PsycInfo数据库记录(c)2025美国心理学会,保留所有权利)

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