潜伏特征分析通过异常显著性识别出四种不同的临床精神分裂症特征。

IF 3 Q2 PSYCHIATRY Schizophrenia (Heidelberg, Germany) Pub Date : 2024-10-18 DOI:10.1038/s41537-024-00514-9
Matteo Aloi, Renato de Filippis, Elvira Anna Carbone, Marianna Rania, Angela Bertuca, Marisa Golia, Rosina Nicoletta, Cristina Segura-Garcia, Pasquale De Fazio
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摘要

了解异常显著性(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。研究人员强调了显著性归因在精神分裂症中的重要性,承认它与环境压力因素和多种神经递质系统之间存在相互作用。童年创伤和逆境(CTA)在 SSD 中扮演着重要角色,有可能导致以 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,但不同的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,参与者完成的评估包括异常显著性量表(ASI)、童年创伤问卷-简表(CTQ-SF)和阳性与阴性症状量表(PANSS)。我们采用潜伏特征分析(LPA)来识别样本中不同的强直性脊柱炎特征,并对这些特征之间的精神病理变量差异进行了后续分析。在 262 名参与者中,通过 LPA 发现了四种不同的 AS 特征:低 AS、伴有严重症状和 CTA 的高 AS、伴有性虐待相关性的中度 AS 和伴有特定童年创伤的慢性 AS。特征的区别包括年龄、住院情况、精神病症状和 CTA 的差异。逻辑回归分析表明,四种特征与情感虐待、性虐待、身体忽视和临床变量之间存在显著关联。根据强直性脊柱炎对患有自闭症的患者进行细分,发现了四种不同的特征,每种特征都有其独特的临床特征以及与 CTA 的关联。未来的研究应探讨这些特征是否与不同的治疗结果相对应。这些发现凸显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。
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Latent profile analysis identifies four different clinical schizophrenia profiles through aberrant salience.

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.

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