在通往精神病谱系障碍的途径上测试综合性模型:对人口层面的预防性干预措施的影响
Yamin Zhang1,2, Jeremy Coid3
1Department of Prevention and Control, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Psychological medicine
|March 13, 2025
概括
童年逆境 (CA) 通过暴力,性行为和滥用物质的综合症导致精神病谱系障碍 (PSD). 针对CA的发展影响的预防策略对于减少PSD风险至关重要.
科学领域:
- 精神病学和心理健康 精神病学和心理健康
- 健康的社会决定因素
- 流行病学 流行病学
背景情况:
- 人口层面的预防性干预对精神病至关重要,特别是当受社会决定因素影响时.
- 童年逆境 (CA) 是精神病谱系障碍 (PSD) 的重要危险因素.
- 综合性模型提供了一个框架,以了解各种风险因素的相互作用,有助于PSD.
研究的目的:
- 测试三个综合症模型,检查从童年逆境 (CA) 到精神病谱系障碍 (PSD) 的途径.
- 调查这些综合症模型对人口级预防干预措施的影响.
- 在CA和PSD的背景下探索暴力/犯罪 (VC),性行为 (SH) 和物质滥用 (SM) 的作用.
主要方法:
- 在5个人口小组中对7461名英国男性进行了横截面分析.
- 测试VC,SH和SM之间的添加和乘法协同相互作用,考虑CA和成人创伤性生活事件.
- 调解和部分最小平方路径建模,以评估从CA和综合性因素到PSD的路径.
主要成果:
- 在患有CA和创伤性生活事件的男性中,观察到VC,SH和SM之间的多重协同相互作用.
- 药物滥用 (SM) 被确定为从CA到PSD的途径的唯一调解者.
- 创伤性生活事件通过综合性途径影响PSD,没有直接影响.
- 较高的综合症评分和剥夺的特征是男性有PSD和CA.
结论:
- PSD可以广泛分为生物驱动的病例和受社会决定因素影响的病例,包括与CA相关的综合征途径.
- 预防策略应优先考虑减轻CA对导致PSD的途径的不良发育影响.
- 在青春期和早期成年期对药物滥用 (SM) 进行有针对性的干预,可以防止在有 CA 病史的脆弱个体中引发效应.
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