International Journal of Methods in Psychiatric Research最新文献_第10页

Examining the factor structure of the DSM-5 Level 1 cross-cutting symptom measure 检验DSM-5第一级横切症状量表的因素结构

IF 3.1 3区医学 Q2 PSYCHIATRY

International Journal of Methods in Psychiatric Research

Pub Date : 2022-11-01 DOI: 10.1002/mpr.1953

Alison B. Gibbons, Cristan Farmer, Jacob S. Shaw, Joyce Y. Chung

Objectives

The DSM-5 Level 1 Cross-Cutting Symptom Measure (DSM-XC) was developed by the American Psychiatric Association as a transdiagnostic mental health symptom survey. Despite its promise as a screening tool, few studies have assessed its latent dimensionality or provided guidance on interpreting responses. We examined the factor structure of the DSM-XC in a convenience sample of participants with varying degrees of psychopathology.

Methods

Participants (n = 3533) were enrolled in an online study on the mental health impact of COVID-19 (NCT04339790). We used a factor analytic framework with exploratory and confirmatory analyses to evaluate candidate factor solutions. Convergent validity analysis with concurrent study measures was also performed.

Results

Six-factor and bifactor candidate solutions both had good fit and full measurement invariance across age, sex, and enrollment date. The six-factor solution resulted in constructs labeled as: mood, worry, activation, somatic, thought, and substance use. A general psychopathology factor and two residual factors (mood and anxiety constructs) explained the variance of the bifactor solution.

Conclusions

Our analysis supports that the DSM-XC is a multidimensional instrument spanning many mental health symptoms. We provide scoring solutions for two factor structures that capture broader constructs of psychopathology. Use of a convenience sample may limit generalizability of findings.

目的DSM-5第一级交叉症状测量(DSM-XC)是由美国精神病学协会开发的一项跨诊断精神健康症状调查。尽管它有望成为一种筛查工具，但很少有研究评估其潜在维度或为解释反应提供指导。我们检验了DSM-XC在不同程度的精神病理参与者的方便样本的因素结构。方法参与者(n = 3533)加入一项关于COVID-19心理健康影响的在线研究(NCT04339790)。我们使用具有探索性和验证性分析的因子分析框架来评估候选因子解决方案。采用并行研究措施进行了收敛效度分析。结果六因素和双因素候选解在年龄、性别和入组日期上均具有良好的拟合和完全的测量不变性。六因素解决方案的结果是:情绪、担忧、激活、躯体、思想和物质使用。一个一般的精神病理因素和两个残余因素(情绪和焦虑结构)解释了双因素解决方案的差异。结论:我们的分析支持DSM-XC是一个涵盖许多心理健康症状的多维工具。我们为捕获精神病理学更广泛的结构的两个因素结构提供评分解决方案。使用方便样本可能会限制结果的普遍性。

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引用次数: 0

Design and methods of the Longitudinal Eating Disorders Assessment Project research consortium for veterans 退伍军人饮食失调纵向评估项目研究联盟的设计与方法

IF 3.1 3区医学 Q2 PSYCHIATRY

International Journal of Methods in Psychiatric Research

Pub Date : 2022-10-17 DOI: 10.1002/mpr.1941

Kelsie T. Forbush, Trevor J. Swanson, Melinda Gaddy, Mary Oehlert, Alesha Doan, Robert W. Morgan, Colin O’Brien, Yiyang Chen, Kylie Christian, Q. Chelsea Song, David Watson, Joanna Wiese

Introduction

Military service members must maintain a certain body mass index and body fat percentage. Due to weight-loss pressures, some service members may resort to unhealthy behaviors that place them at risk for the development of an eating disorder (ED).

Objectives

To understand the scope and impact of EDs in military service members and veterans, we formed the Longitudinal Eating Disorders Assessment Project (LEAP) Consortium. LEAP aims to develop novel screening, assessment, classification, and treatment tools for veterans and military members with a focus on EDs and internalizing psychopathology.

Methods

We recruited two independent nationally representative samples of post-9/11 veterans who were separated from service within the past year. Study 1 was a four-wave longitudinal survey and Study 2 was a mixed-methods study that included surveys, structured-clinical interviews, and qualitative interviews.

Results

Recruitment samples were representative of the full population of recently separated veterans. Sample weights were created to adjust for sources of non-response bias to the baseline survey. Attrition was low relative to past studies of this population, with only (younger) age predicting attrition at 1-week follow-up.

Conclusions

We expect that the LEAP Consortium data will contribute to improved information about EDs in veterans, a serious and understudied problem.

军人必须保持一定的身体质量指数和体脂率。由于减肥的压力，一些服役人员可能会采取不健康的行为，使他们有可能患上饮食失调症(ED)。目的为了了解军人和退伍军人饮食失调的范围和影响，我们成立了纵向饮食失调评估项目(LEAP)联盟。LEAP旨在为退伍军人和军人开发新的筛查、评估、分类和治疗工具，重点关注急症和内化精神病理学。方法我们招募了两个独立的具有全国代表性的样本，这些样本是在过去一年内从9/11后退伍军人中分离出来的。研究1是一项四波纵向调查，研究2是一项混合方法研究，包括调查、结构化临床访谈和定性访谈。结果招募样本具有代表性的是新近退伍军人的全部人口。创建样本权重是为了调整基线调查无反应偏差的来源。与过去对该人群的研究相比，减员率较低，只有(更年轻的)年龄预测了1周随访时的减员率。我们期望LEAP联盟的数据将有助于改善退伍军人急诊科的信息，这是一个严重而尚未得到充分研究的问题。

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引用次数: 0

An 18-month follow-up of the Covid-19 psychology research consortium study panel: Survey design and fieldwork procedures for Wave 6 对Covid-19心理学研究联盟研究小组进行为期18个月的随访:第6波的调查设计和实地调查程序

IF 3.1 3区医学 Q2 PSYCHIATRY

International Journal of Methods in Psychiatric Research

Pub Date : 2022-10-10 DOI: 10.1002/mpr.1949

Orla McBride, Sarah Butter, Anton P. Martinez, Mark Shevlin, Jamie Murphy, Todd K. Hartman, Ryan McKay, Philip Hyland, Kate M. Bennett, Thomas V. A. Stocks, Jilly Gibson-Miller, Liat Levita, Liam Mason, Richard P. Bentall

Objectives

Established in March 2020, the C19PRC Study monitors the psychological and socio-economic impact of the pandemic in the UK and other countries. This paper describes the protocol for Wave 6 (August–September 2021).

Methods

The survey assessed: COVID-19 related experiences; experiences of common mental health disorders; psychological characteristics; and social and political attitudes. Adult participants from any previous wave (N = 3170) were re-invited, and sample replenishment procedures helped manage attrition. Weights were calculated using a survey raking algorithm to ensure the on-going original panel (from baseline) was nationally representative in terms of gender, age, and household income, amongst other factors.

Results

1643 adults were re-interviewed at Wave 6 (51.8% retention rate). Non-participation was higher younger adults, those born outside UK, and adults living in cities. Of the adults recruited at baseline, 54.3% (N = 1100) participated in Wave 6. New respondent (N = 415) entered the panel at this wave, resulting in cross-sectional sample for Wave 6 of 2058 adults. The raking procedure re-balanced the longitudinal panel to within 1.3% of population estimates for selected socio-demographic characteristics.

Conclusions

This paper outlines the growing strength of the publicly available C19PRC Study data for COVID-19-related interdisciplinary research.

C19PRC研究于2020年3月启动，监测疫情对英国和其他国家的心理和社会经济影响。本文描述了Wave 6(2021年8月至9月)的协议。方法调查评估:COVID-19相关经验;常见精神健康障碍的经验;心理特点;以及社会和政治态度。从之前的任何一波成年参与者(N = 3170)被重新邀请，样品补充程序有助于管理损耗。使用调查排序算法计算权重，以确保正在进行的原始小组(从基线开始)在性别、年龄、家庭收入等因素方面具有全国代表性。结果1643名成人在第6波重新接受了访谈，保留率为51.8%。不参与的年轻人、在英国以外出生的人和生活在城市的成年人比例更高。在基线时招募的成年人中，54.3% (N = 1100)参加了第6波。新的被调查者(N = 415)在这一波进入小组，产生了第6波2058名成年人的横断面样本。倾斜程序重新平衡了纵向面板，使其在选定社会人口特征的人口估计的1.3%以内。本文概述了在covid -19相关跨学科研究中，可公开获得的C19PRC研究数据日益强大。

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引用次数: 2

The Concise Health Risk Tracking - Self-Report (CHRT-SR)—A measure of suicidal risk: Performance in adolescent outpatients 简明健康风险追踪-自我报告(CHRT-SR) -衡量自杀风险:青少年门诊患者的表现

IF 3.1 3区医学 Q2 PSYCHIATRY

International Journal of Methods in Psychiatric Research

Pub Date : 2022-10-10 DOI: 10.1002/mpr.1944

Karabi Nandy, A. John Rush, Thomas J. Carmody, Alexandra Kulikova, Taryn L. Mayes, Graham Emslie, Madhukar H. Trivedi

Objectives

The Concise Health Risk Tracking Self-Report (CHRT-SR) assesses the risk of suicidal behavior. We report its psychometric properties in a representative sample of adolescent outpatients.

Methods

A sample (n = 657) of adolescents (<18 years of age) in primary or psychiatric care completed the 14-item version of CHRT-SR at both baseline and within 3 months. To identify an optimal brief solution for the scale, we evaluated the factor structure of CHRT-SR using multigroup confirmatory factor analysis, and testing measurement invariance across age and gender. The item response theory and classical test theory characteristics of the optimal solution were evaluated. Concurrent validity (both cross-sectional and as a change measure over time) of the optimal solution was assessed by comparing it to another suicide measure.

Results

Confirmatory factor analysis identified the 9-item CHRT-SR (CHRT-SR₉) as the optimal solution. Classical test theory and item response theory indicated excellent fit. Concurrent validity analyses revealed that it can measure both improvement/worsening of suicidality over time.

Conclusion

The CHRT-SR₉ is a brief self-report with excellent psychometric properties in a sample of adolescents that is sensitive to changes in suicidality over time. Its performance in other populations and ability to predict future suicidal events deserves study.

目的用简明健康风险追踪自我报告(CHRT-SR)评估自杀行为的风险。我们在青少年门诊患者的代表性样本中报告其心理测量特性。方法657名接受初级或精神科治疗的青少年(18岁)在基线和3个月内完成了14项CHRT-SR。为了确定量表的最佳简短解决方案，我们使用多组验证性因子分析评估了CHRT-SR的因素结构，并检验了不同年龄和性别的测量不变性。评价了最优解的项目反应理论和经典测试理论的特点。通过将最佳解决方案与另一种自杀措施进行比较来评估其并发效度(包括横截面和随时间变化的测量)。结果验证性因子分析确定9项CHRT-SR (CHRT-SR9)为最优方案。经典测试理论和项目反应理论均显示出良好的拟合性。同时效度分析显示，它可以测量随时间推移自杀行为的改善/恶化。结论CHRT-SR9是一份对自杀倾向随时间变化敏感的青少年样本的简短自我报告，具有良好的心理测量特性。它在其他人群中的表现和预测未来自杀事件的能力值得研究。

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引用次数: 6

Crime, mortality and neurocognitive disorders: A nationwide register study in Finland 犯罪、死亡率和神经认知障碍:芬兰的一项全国性登记研究

IF 3.1 3区医学 Q2 PSYCHIATRY

International Journal of Methods in Psychiatric Research

Pub Date : 2022-09-30 DOI: 10.1002/mpr.1948

Tiina Talaslahti, Milena Ginters, Hannu Kautiainen, Risto Vataja, Anniina Palm, Henrik Elonheimo, Jaana Suvisaari, Nina Lindberg, Hannu Koponen

Objectives

To explore mortality of patients with Alzheimer's disease (AD), frontotemporal dementia (FTD), or Lewy body dementias (LBD) who had criminal behavior in the year preceding diagnosis.

Methods

Data were obtained from the nationwide registers. Mortality was compared between disorder groups with and without criminal acts and with the general population. The cohort included patients who had received a discharge register diagnosis of AD (N = 80,540), FTD (N = 1060), or LBD (N = 10,591) between 1998 and 2015. The incidences of crimes were calculated in the year preceding diagnosis. We further calculated age- and sex-adjusted survivals of different dementia groups with and without criminal acts, and in relation to the general population (SMR, Standardized Mortality Ratio).

Results

Criminal behavior was more common in men than in women. It was associated with decreased mortality in the AD group. SMRs due to unnatural causes, and in the LBD and FTD female groups, were higher in patients with criminal behavior than in those without.

Conclusion

LBD and female FTD patients, who had criminal behavior before diagnosis, were at higher risk of death than patients without such behavior. Novel criminality in older adults may be associated with neurocognitive disorder, in which case medical attention is justified.

目的探讨阿尔茨海默病(AD)、额颞叶痴呆(FTD)、路易体痴呆(LBD)患者诊断前一年有犯罪行为的死亡率。方法收集全国登记资料。比较了有和没有犯罪行为的紊乱组与一般人群之间的死亡率。该队列包括1998年至2015年间出院登记诊断为AD (N = 80540)、FTD (N = 1060)或LBD (N = 10591)的患者。犯罪的发生率是在诊断前一年计算的。我们进一步计算了不同痴呆组的年龄和性别调整后的生存率，包括有和没有犯罪行为，以及与一般人群的关系(SMR，标准化死亡率)。结果男性的犯罪行为高于女性。它与阿尔茨海默病组死亡率降低有关。在LBD和FTD女性组中，非自然原因导致的smr在有犯罪行为的患者中高于无犯罪行为的患者。结论诊断前有犯罪行为的LBD和女性FTD患者死亡风险高于无犯罪行为的患者。老年人的新犯罪行为可能与神经认知障碍有关，在这种情况下，医疗护理是合理的。

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引用次数: 0

Dementia in health claims data: The influence of different case definitions on incidence and prevalence estimates 健康索赔数据中的痴呆:不同病例定义对发病率和患病率估计的影响

IF 3.1 3区医学 Q2 PSYCHIATRY

International Journal of Methods in Psychiatric Research

Pub Date : 2022-09-27 DOI: 10.1002/mpr.1947

Oliver Riedel, Malte Braitmaier, Ingo Langner

Objectives

The epidemiology of dementia subtypes including Alzheimer's disease (AD) and vascular dementia (VD) and their reliance on different case definitions (“algorithms”) in health claims data are still understudied.

Methods

Based on health claims data, prevalence estimates (per 100 persons), incidence rates (IRs, per 100 person-years), and proportions of AD, VD, and other dementias (oD) were calculated. Five algorithms of increasing strictness considered inpatient/outpatient diagnoses (#1, #2), antidementia drugs (#3) or supportive diagnostics (#4, #5).

Results

Algorithm 1 detected 213,409 cases (#2: 197,400; #3: 48,688; #4: 3033; #5: 3105), a prevalence for any dementia of 3.44 and an IR of 1.39 (AD: 0.80/0.21, VD: 0.79/0.31). The prevalence decreased by algorithms for any dementia (#2: 3.19; #3: 0.75; #4: 0.04; #5: 0.05) as did IRs (#2: 1.13; #3: 0.18; #4: 0.05, #5: 0.05). Algorithms 1–2, and 4–5 revealed similar proportions of AD (23.3%–26.6%), VD (19.9%–23.2%), and oD (53.1%–53.8%), algorithm 3 estimated 45% (AD), 12.1% (VD), and 43.0% (oD).

Conclusions

Health claims data show lower estimates of AD than previously reported, due to markedly lower prevalent/incident proportions of patients with corresponding codes. Using medication in defining dementia potentially improves estimating the proportion of AD while supportive diagnostics were of limited use.

包括阿尔茨海默病(AD)和血管性痴呆(VD)在内的痴呆亚型的流行病学及其对健康声明数据中不同病例定义(“算法”)的依赖程度仍未得到充分研究。方法基于健康声明数据，计算患病率估计(每100人)、发病率(IRs，每100人年)以及AD、VD和其他痴呆(oD)的比例。五种提高严格程度的算法考虑了住院/门诊诊断(#1，#2)，抗痴呆药物(#3)或支持性诊断(#4，#5)。算法1检测到213409例(算法2:197400例;# 3: 48688;# 4: 3033;#5: 3105)，痴呆患病率为3.44,IR为1.39 (AD: 0.80/0.21, VD: 0.79/0.31)。算法降低了任何痴呆症的患病率(#2:3.19;# 3: 0.75;# 4: 0.04;#5: 0.05)， ir (#2: 1.13;# 3: 0.18;#4: 0.05， #5: 0.05)算法1-2和算法4-5显示AD(23.3% ~ 26.6%)、VD(19.9% ~ 23.2%)和oD(53.1% ~ 53.8%)的比例相似，算法3估计AD(45%)、VD(12.1%)和oD(43.0%)。健康索赔数据显示，由于相应编码的患者患病率/发病率明显较低，因此AD的估计比先前报道的要低。使用药物来定义痴呆可能会改善对AD比例的估计，而支持性诊断的作用有限。

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引用次数: 1

Testing Bayesian models of belief updating in the context of depressive symptomatology 抑郁症状背景下信念更新的贝叶斯模型检验

IF 3.1 3区医学 Q2 PSYCHIATRY

International Journal of Methods in Psychiatric Research

Pub Date : 2022-09-17 DOI: 10.1002/mpr.1946

Matthias Feldmann, Tobias Kube, Winfried Rief, Eva-Lotta Brakemeier

Objectives

Predictive processing approaches to belief updating in depression propose that depression is related to more negative and more precise priors. Also, belief updating is assumed be negatively biased in comparison to normative Bayesian updating. There is a lack of efficient methods to mathematically model belief updating in depression.

Methods

We validated a novel performance belief updating paradigm in a nonclinical sample (N = 133). Participants repeatedly participated in a non-self-related emotion recognition task and received false feedback. Effects of the feedback manipulation and differences in depressive symptoms on belief updating were analysed in Bayesian multilevel analyses.

Results

Beliefs were successfully manipulated through the feedback provided. Depressive symptoms were associated with more negative updating than normative Bayesian updating but results were influenced by few cases. No evidence of biased change in beliefs or overly precise priors was found. Depressive symptoms were associated with more negative updating of generalised performance beliefs.

Conclusions

There was cautious support for negatively biased belief updating associated with depressive symptoms, especially for generalised beliefs. The content of the task may not be self-relevant enough to cause strong biases. Further explication of Bayesian models of depression and replication in clinical samples is needed.

目的研究抑郁症信念更新的预测加工方法，提出抑郁症与更负性和更精确的先验相关。此外，与规范贝叶斯更新相比，信念更新被认为是负偏的。目前尚无有效的方法对抑郁症患者的信念更新进行数学建模。方法:我们在非临床样本(N = 133)中验证了一种新的绩效信念更新范式。参与者反复参与非自我相关的情绪识别任务，并得到错误的反馈。采用贝叶斯多水平分析分析反馈操作和抑郁症状差异对信念更新的影响。结果通过反馈，成功地操纵了信念。与规范贝叶斯更新相比，抑郁症状与负性更新的相关程度更高，但结果受少数病例的影响。没有证据表明有偏见的信念改变或过于精确的先验。抑郁症状与更消极地更新一般表现信念有关。结论消极偏见信念更新与抑郁症状相关，尤其是广义信念更新。任务的内容可能没有足够的自我相关性，从而导致强烈的偏见。需要进一步解释贝叶斯抑郁症模型并在临床样本中复制。

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引用次数: 2

Are effort-based decision-making tasks worth the effort?—A study on the associations between effort-based decision-making tasks and self-report measures 基于努力的决策任务值得付出努力吗?基于努力的决策任务与自我报告测量之间关系的研究

IF 3.1 3区医学 Q2 PSYCHIATRY

International Journal of Methods in Psychiatric Research

Pub Date : 2022-09-10 DOI: 10.1002/mpr.1943

Katharina E. Renz, Björn Schlier, Tania M. Lincoln

Objectives

Amotivation is a common symptom in various mental disorders, including psychotic or depressive disorders. Effort-based decision-making (EBDM)-tasks quantifying amotivation at a behavioral level have been on the rise. Task performance has been shown to differentiate patient groups from healthy controls. However, findings on indicators of construct validity, such as the correlations between different tasks and between tasks and self-reported/observer-rated amotivation in clinical and healthy samples have been inconclusive.

Methods

In a representative community sample (N = 90), we tested the construct validity of the Deck Choice Task, the Expenditure for Rewards Task and the Balloon Task. We calculated correlations between the EBDM-tasks and between the EBDM-tasks and self-reported amotivation, apathy, anticipatory pleasure, and BIS/BAS.

Results

Correlations between tasks were low to moderate (0.198 ≤ r ≤ 0.358), with the Balloon Task showing the largest correlations with the other tasks, but no significant correlations between any EBDM-task and the self-report measures.

Conclusion

Although different EBDM-tasks are conceptualized to measure the same construct, a large part of what each task measures could not be accounted for by the other tasks. Moreover, the tasks did not appear to substantially capture what was measured in established self-report instruments for amotivation in our sample, which could be interpreted as questioning the construct validity of EBDM-tasks.

动机是各种精神障碍的常见症状，包括精神病或抑郁症。基于努力的决策(EBDM)-在行为层面量化动机的任务一直在上升。任务表现已被证明可以将患者组与健康对照组区分开来。然而，在临床和健康样本中，不同任务之间以及任务与自我报告/观察者评价动机之间的相关性等构念效度指标的研究结果尚无定论。方法在一个有代表性的社区样本(N = 90)中，我们测试了甲板选择任务、奖励支出任务和气球任务的结构效度。我们计算了ebdm任务之间的相关性，以及ebdm任务与自我报告的动机、冷漠、预期愉悦和BIS/BAS之间的相关性。结果各任务之间的相关性为低至中等(0.198≤r≤0.358)，气球任务与其他任务的相关性最大，而ebdm任务与自我报告测量之间无显著相关性。结论虽然不同的ebdm任务被概念化来测量相同的结构，但每个任务测量的大部分内容不能被其他任务所解释。此外，在我们的样本中，这些任务似乎并没有实质性地捕捉到在既定的自我报告工具中测量到的动机，这可以解释为质疑ebdm任务的结构有效性。

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引用次数: 0

Association between mental health and academic performance among university undergraduates: The interacting role of lifestyle behaviors 大学生心理健康与学业成绩的关系:生活方式行为的交互作用

IF 3.1 3区医学 Q2 PSYCHIATRY

International Journal of Methods in Psychiatric Research

Pub Date : 2022-09-10 DOI: 10.1002/mpr.1938

Tianshu Chu, Xin Liu, Shigemi Takayanagi, Tomoko Matsushita, Hiro Kishimoto

Objectives

Impaired mental health status tends to be associated with poor academic performance, but few prospective studies have examined the association between mental health and academic performance among undergraduates while considering the interacting roles of multiple lifestyle behaviors.

Participants and Methods

A total of 1823 Japanese undergraduate students (67% men) were followed up for 4 years. Their mental health status was measured by the six-item Kessler Psychological Distress Scale (K6). We defined poor academic performance as a grade point average (GPA) <2.0. Cox proportional hazards models were used to determine the relationship between the students' mental health status and the incident risk of poor academic performance.

Results

Our analyses revealed that impaired mental health status in the first semester of university study significantly predicted an increased incident risk of poor academic performance during the overall undergraduate period. This association remained significant when the health lifestyle behaviors were adjusted, and the hazard ratio (95% confidence interval) for poor academic performance was 1.62 (1.18–2.23). This significant association disappeared in the low-lifestyle-behavior-risk group.

Conclusion

Impaired mental health status in the first semester significantly predicts an increased incident risk of poor academic performance during the undergraduate period.

目的心理健康状况受损往往与学习成绩差有关，但很少有前瞻性研究在考虑多种生活方式行为相互作用的情况下，考察大学生心理健康与学习成绩之间的关系。对象与方法对1823名日本大学生(男性67%)进行为期4年的随访。采用六项Kessler心理困扰量表(K6)对其心理健康状况进行测量。我们将糟糕的学业表现定义为平均绩点(GPA) 2.0。采用Cox比例风险模型确定学生心理健康状况与学业成绩不良事件风险的关系。结果大学第一学期的心理健康状况受损显著预示着整个本科期间学习成绩不佳的事件风险增加。当调整健康生活方式行为时，这种关联仍然显著，学习成绩差的风险比(95%置信区间)为1.62(1.18-2.23)。这种显著的关联在低生活方式-行为风险组中消失了。结论第一学期心理健康状况不良显著预示着本科阶段学业成绩不良事件风险的增加。

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引用次数: 0

Phenotyping suicidal ideation and behavior: Comparing clinical characteristics and future suicide attempts between suicidal subtypes in two clinical samples 自杀意念和行为的表型:比较两个临床样本中自杀亚型的临床特征和未来的自杀企图

IF 3.1 3区医学 Q2 PSYCHIATRY

International Journal of Methods in Psychiatric Research

Pub Date : 2022-09-03 DOI: 10.1002/mpr.1940

Lena Spangenberg, Michael Friedrich, Thomas Forkmann, Nina Hallensleben, Antje Schönfelder, Dajana Rath, Laura Paashaus, Tobias Teismann, Heide Glaesmer

Objectives

To further validate the concept of suicidal subtypes distinguished by indicators of suicidal thinking and behavior with regard to clinical characteristics and past and future suicide attempts.

Methods

Psychiatric inpatients were assessed (study 1: ecological momentary assessments in 74 depressed inpatients with suicidal ideation; study 2: clinical assessments in 224 inpatients after a suicide attempt and over a 12-month follow-up period). Subtypes were identified using latent profile analysis (based on indicators of real-time suicide ideation) and latent class analysis (based on features of past suicide ideation and suicide attempt characteristics). Comparisons between subtypes included clinical characteristics (depression, suicidal ideation, trait impulsivity, childhood trauma) as well as past (study 1) and future (study 2) suicide attempts.

Results

Suicidal subtypes emerged that are characterized by suicidal ideation means and stability and features of past suicidal behavior (four in study 1, three in study 2). The subtypes differed in terms of depression/suicidal ideation, but not in terms of trait impulsivity/childhood trauma. Although not significant, the subtypes “high-stable” and “low-moderate stable” reported multiple re-attempts more frequently during follow-up than the “low-stable” subtype in study 2.

Conclusion

Differences in clinical variables (and by trend in future suicide attempts) clearly point to the clinical relevance of suicidal subtypes (with variability of suicidal thoughts playing a particularly important role).

目的进一步验证以自杀思维和行为指标区分的自杀亚型的概念，包括临床特征、过去和未来的自杀企图。方法对精神病住院患者进行评估（研究1：对74名有自杀意念的抑郁症住院患者进行生态瞬时评估；研究2：对224名自杀未遂后的住院患者进行12个月随访期的临床评估）。使用潜在特征分析（基于实时自杀意念的指标）和潜在类别分析（基于过去自杀意念的特征和自杀未遂特征）来识别亚型。亚型之间的比较包括临床特征（抑郁、自杀意念、特质冲动、儿童创伤）以及过去（研究1）和未来（研究2）的自杀企图。结果出现了以自杀意念方式、既往自杀行为的稳定性和特征为特征的自杀亚型（研究1为4种，研究2为3种）。亚型在抑郁/自杀意念方面存在差异，但在特质冲动/童年创伤方面没有差异。尽管不显著，但在研究2中，“高稳定”和“低-中稳定”亚型在随访期间比“低稳定”亚类型更频繁地报告了多次重复尝试。结论临床变量的差异（以及未来自杀企图的趋势）清楚地表明了自杀亚型的临床相关性（自杀想法的可变性起着特别重要的作用）。

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引用次数: 1