Williams Guido L, de Beurs Edwin, Spinhoven Philip
Institute of Psychology, Leiden University, Leiden, The Netherlands.
LMcare, Amsterdam, The Netherlands.
BMC Psychol. 2025 Jul 1;13(1):639. doi: 10.1186/s40359-025-02946-z.
The objective of this study was to investigate latent response patterns in symptom severity, as measured by the Brief Symptom Inventory (BSI), and limitations in daily functioning, as assessed by the extended PROMIS item bank 'Ability to Participate in Social Roles and Activities' (APSRA), within a sample of psychiatric outpatients. In addition to identifying classes with converging test results, we hypothesized the existence of classes with divergent results: those exhibiting low symptom severity alongside severe functional limitations, and those demonstrating high symptom severity while maintaining high levels of functioning.
A sample of 1,010 psychiatric outpatients from the Netherlands completed the Dutch BSI and APSRA. Latent Profile Analysis (LPA) was employed to group patients with similar patterns in symptom severity and daily functioning limitations. After identifying the LPA classes and class membership of all patients, we analyzed the distribution of suicidal ideation, participation level (i.e., employment), diagnosis, age, sex, living situation, and education level, across the LPA classes.
The correlation between APSRA and BSI scores (r = -.64) showed that higher APSRA scores were associated with lower psychopathology. LPA identified four distinct profiles of psychosocial dysfunction: minimal, mild, moderate, and severe. These profiles differed significantly in suicidal ideation and work participation but not in other demographic variables. While diagnosis had a statistically significant effect on class membership, the effect size was negligible. The hypothesized divergent classes were not observed.
The four profiles provide a clinically relevant framework for understanding self-reported psychosocial dysfunction, distinguishing patients on key outcomes such as suicidal ideation and work participation. This approach supports tailoring interventions, prioritizing treatment goals, and allocating resources based on shared patterns of characteristics. Future research should validate these profiles' temporal stability and predictive value for treatment outcomes while exploring the benefits of combining symptom and functioning assessments for clinical decision-making.
本研究的目的是调查精神科门诊患者样本中，通过简明症状量表（BSI）测量的症状严重程度的潜在反应模式，以及通过扩展的患者报告结果测量信息系统（PROMIS）项目库“参与社会角色和活动的能力”（APSRA）评估的日常功能限制。除了识别具有趋同测试结果的类别外，我们还假设存在具有不同结果的类别：即症状严重程度低但功能严重受限的类别，以及症状严重程度高但功能水平保持较高的类别。
来自荷兰的1010名精神科门诊患者完成了荷兰版的BSI和APSRA。采用潜在类别分析（LPA）对症状严重程度和日常功能限制具有相似模式的患者进行分组。在确定所有患者的LPA类别和类别归属后，我们分析了自杀意念、参与水平（即就业情况）、诊断、年龄、性别、生活状况和教育水平在LPA类别中的分布情况。
APSRA与BSI评分之间的相关性（r = -0.64）表明，APSRA得分越高，心理病理学程度越低。LPA识别出四种不同的心理社会功能障碍概况：轻微、轻度、中度和重度。这些概况在自杀意念和工作参与方面存在显著差异，但在其他人口统计学变量方面没有差异。虽然诊断对类别归属有统计学上的显著影响，但效应大小可以忽略不计。未观察到假设的不同类别。
这四种概况为理解自我报告的心理社会功能障碍提供了一个临床相关框架，在自杀意念和工作参与等关键结果方面区分患者。这种方法支持根据共同的特征模式量身定制干预措施、确定治疗目标的优先级并分配资源。未来的研究应验证这些概况的时间稳定性和对治疗结果的预测价值，同时探索将症状和功能评估相结合用于临床决策的益处。
