Yu Bryan Ho-Wang, Chau Anson Kai Chun, Chiu Chui- De, So Suzanne Ho-Wai
Department of Psychology, The Chinese University, 3/F Wong Foo Yuan Building, Hong Kong SAR, China.
Soc Psychiatry Psychiatr Epidemiol. 2025 Sep 15. doi: 10.1007/s00127-025-02992-3.
Psychosis and dissociation are inter-correlated syndromes. As they are both multifaceted constructs, individuals experiencing positive psychotic and dissociative symptoms may have heterogeneous presentations of co-occurring symptomatology. This study aimed to identify phenotypes of individuals with varying degrees of these co-occurring symptoms in the general population, while also examining the impact of childhood trauma and prospective emotional and functional outcomes associated with these phenotypes.
Participants were recruited from the general population through diverse means. At baseline and six months after, adults (age 18-65) were assessed for positive psychotic symptoms, dissociative symptoms, depression, anxiety, and functioning using an online survey. Childhood trauma was assessed at baseline only. Distinct subgroups were estimated by latent profile analysis, with childhood trauma examined as predictor of the profiles. The identified profiles were compared on emotional and functional outcomes at both timepoints.
The community sample consisted of 2,958 individuals (mean age = 34.69; 72.5% female). Four distinct profiles were identified - 'low overall', 'moderate (hallucinatory)', 'moderate (dissociative)', and 'high overall'. Emotional/sexual abuse and physical neglect notably differentiated the 'low overall' profile from the other three profiles, with sexual abuse specifically linked to the 'high overall' and 'moderate (hallucinatory)' profiles. The 'high overall' and 'moderate (dissociative)' profiles exhibited persistent elevated depression across timepoints than the other profiles.
Distinct profiles of varying levels of co-occurring positive psychotic and dissociative symptoms were identified in the general population. The implications for early identification and intervention of these commonly co-occurring symptoms are discussed.
精神病性症状与解离症状是相互关联的综合征。由于它们都是多方面的概念，出现阳性精神病性症状和解离症状的个体可能有同时出现的症状的异质性表现。本研究旨在识别普通人群中具有不同程度这些同时出现症状的个体的表型，同时研究童年创伤的影响以及与这些表型相关的前瞻性情绪和功能结局。
通过多种方式从普通人群中招募参与者。在基线和六个月后，使用在线调查对18至65岁的成年人进行阳性精神病性症状、解离症状、抑郁、焦虑和功能评估。童年创伤仅在基线时进行评估。通过潜在类别分析估计不同的亚组，并将童年创伤作为类别的预测因素进行检验。在两个时间点对识别出的类别在情绪和功能结局方面进行比较。
社区样本包括2958名个体（平均年龄 = 34.69岁；72.5%为女性）。识别出四个不同的类别——“总体低”、“中度（幻觉性）”、“中度（解离性）”和“总体高”。情感/性虐待和身体忽视显著区分了“总体低”类别与其他三个类别，性虐待尤其与“总体高”和“中度（幻觉性）”类别相关。与其他类别相比，“总体高”和“中度（解离性）”类别在各时间点的抑郁水平持续升高。
在普通人群中识别出了同时出现的阳性精神病性症状和解离症状的不同程度的独特类别。讨论了对这些常见同时出现症状进行早期识别和干预的意义。
