Comorbidity of psychiatric and substance use disorders in late adolescence: A cluster analytic approach
Comorbidity of psychiatric and substance use disorders in late adolescence: A cluster analytic approach
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DOI：
10.1081/ada-100104510
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发表时间：
2001-01-01
影响因子：
2.7
通讯作者：
Wilson, B
中科院分区：
文献类型：
--
作者：
Beitchman, JH;Adlaf, EM;Wilson, B
使用聚类分析来确定过去一年患有物质和/或精神障碍的青年亚组(N=110，平均年龄19.0岁)。这项研究的数据来自一项基于社区的前瞻性纵向调查，对象是言语/语言障碍儿童(S/L)和匹配的对照组，他们在5岁时参加了广泛的诊断和心理社会评估，并在随访时再次参加。分组变量是基于密歇根大学综合国际诊断访谈在19岁时评估的五个DSM诊断类别。采用Ward的方法，将五个二元变量输入到等级聚类分析中。然后使用迭代聚类方法(K-Means)来精炼Ward解。最后，进行一系列方差分析(ANOVA)，以分析不同组之间在全球功能评估(GAF)、犯罪介入、焦虑和抑郁症状以及吸毒和酗酒频率等指标上的差异。分析产生了8个可重复的聚类组，它们被标记为：(A)焦虑(20.9%)；(B)焦虑饮酒者(5.5%)；(C)抑郁(16.4%)；(D)抑郁的吸毒者(10%)；(E)反社会饮酒者(16.4%)；(F)反社会饮酒者(10%)；(G)吸毒者(8.2%)；(H)酗酒者(12.7%)。这些组通过外部标准进行区分，从而支持我们的集群解决方案的有效性。成群性与S/L损害史有关：抑郁吸毒者和反社会成群组中有很大比例的S/L受损是在5岁时发现的。弄清这些成群组中青少年的发展进程可以为我们提供早期干预和治疗的方法。
Cluster analysis was used to identify subgroups of youths with past-year substance and/or psychiatric disorders (N = 110, mean age 19.0 years). Data for this study came from a community-based, prospective longitudinal investigation of speech/language (S/L) impaired children and matched controls who participated in extensive diagnostic and psychosocial assessments at entry into the study at 5 years of age and again at follow-up. Clustering variables were based on five DSM diagnostic categories assessed at age 19 with the University of Michigan Composite International Diagnostic Interview. Using Ward's method, the five binary variables were entered into a hierarchical cluster analysis. An iterative clustering method (K-means) was then used to refine the Ward solution. Finally, a series of analyses of variance (ANOVAs) were run to analyze group differences between clusters on measures of Global Assessment of Functioning (GAF), criminal involvement, anxiety and depressive symptomatology, and frequency of drug use and heavy drinking. The analysis yielded eight replicablc cluster groups, which were labeled as follows: (a) anxious (20.9%); (b) anxious drinkers (5.5%); (c) depressed (16.4%); (d) depressed drug abusers (10%); (e) antisocial (16.4%); (f) antisocial drinkers (10%); (g) drug abusers (8.2%); (h) problem drinkers (12.7%). These groups were differentiated by external criteria, thus supporting the validity of our cluster solution. Cluster membership was associated with a history of S/L impairment: A large proportion of the depressed drug abusers and the antisocial cluster group had S/L impairment that was identified at age 5. Clarification of the developmental progress of the youths in these cluster groups can inform our approach to early intervention and treatment.