跨诊断阶段的进展从童年到年轻成人
Aswin Ratheesh1,2,3, Yufan Chen1,4, Dylan Hammond2,3
1Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia.
JAMA psychiatry
|September 24, 2025
概括
心理健康分期模型显示,从儿童时期的家族风险向青少年和年轻成人症状的进展,独立于早期生活因素. 这支持了精神疾病临床分期的有效性.
科学领域:
- 精神病学和心理健康研究研究
- 发展心理学 发展心理学
- 流行病学 流行病学
背景情况:
- 越来越多地使用精神障碍的跨诊断临床分期模型.
- 基本假设,特别是关于独立进展的假设,需要进一步调查.
研究的目的:
- 评估从家族风险 (阶段0) 进展到轻度症状 (阶段1a) 和临床显著症状 (阶段1b) 的可能性.
- 独立于潜在的混因素来检查这种进展,并探索介导变量.
主要方法:
- 一项前性队列研究,使用来自阿文长度父母与儿童研究 (ALSPAC) 的数据.
- 包括从出生到24岁的参与者,从1991年到2015年收集数据.
- 对临床阶段0,1a和1b之间的关联进行分析,并根据性别,产科风险和神经认知等混因素进行调整.
主要成果:
- 在儿童家庭风险 (阶段0) 和青少年轻度症状 (阶段1a) (OR,1.65) 之间发现了关联.
- 从青少年轻度症状 (阶段1a) 到年轻成人临床显著症状 (阶段1b) 的进展也显著 (OR,2.07).
- 青春期的神经病症介导了1a阶段和1b阶段之间的关联的18%.
结论:
- 患有早期精神健康问题的年轻人面临着进入后期阶段的高风险.
- 这种进展独立于生命早期的风险因素,支持临床分期模型的核心假设.
- 这些发现证实了临床分期对于理解精神障碍发展的有用性.
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