Temporal relationships between physical symptoms and psychiatric disorder - Results from a national birth cohort
Temporal relationships between physical symptoms and psychiatric disorder - Results from a national birth cohort
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DOI：
10.1192/bjp.173.3.255
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发表时间：
1998-09-01
影响因子：
10.5
通讯作者：
Wessely, S
中科院分区：
文献类型：
--
作者：
Hotopf, M;Mayou, R;Wessely, S
生理症状与精神障碍相关。我们的目的是调查哪个先出现。方法：数据来自医学研究委员会国家健康与发展调查，这是一项基于人口的出生队列研究，使用了两个时间点：36岁和43岁。在两个时间点均报告了6种身体症状。现状：分别在36岁和43岁时进行检查和精神症状频率访谈。对各种混杂因素进行校正的优势比用于描述这两个时间点上身体症状和精神障碍之间的关联。结果精神障碍使报告症状的几率增加3-7倍。当结果被定义为患有多种症状时，这种关系得到加强。导致多重躯体症状的精神障碍和亚综合征障碍的人群归因风险为40.3%。前瞻性地，36岁时的精神障碍是六种身体症状中的五种的预测因子。36岁时出现的三种身体症状预示着43岁时出现的新精神症状。结论精神障碍与躯体症状密切相关。因果关系的方向可以在两个方向上起作用。假设存在因果关系，精神障碍（包括阈下障碍）最多可占多种身体症状病例的40%。
Background Physical symptoms and psychiatric disorder are associated. We aimed to investigate which comes first.Methods Data from the Medical Research Council National Survey of Health and Development, a population-based birth cohort study were used at two time points: 36 and 43 years. Six physical symptoms were reported at both time points. The Present State: Examination and Psychiatric Symptom Frequency interviews were administered at 36 and 43 years respectively. Odds ratios corrected for a variety of confounders were used to describe the associations between physical symptoms and psychiatric disorder across these two time points.Results Psychiatric disorder increased the odds of reporting symptoms 3-7-fold. The relationship strengthened when the outcome was defined as suffering from multiple symptoms. Population attributable risk of psychiatric disorder and subsyndromal disorder in causing multiple somatic symptoms was 40.3%. Prospectively, psychiatric disorder at 36 years was a predictor for five of the six physical symptoms. Three physical symptoms at 36 years predicted new onset of psychiatric symptoms at 43 years.Conclusions Psychiatric disorder is strongly related to physical symptoms. The direction of causality may operate in both directions. Assuming a causal relationship, psychiatric disorder (including subthreshold disorders) could account for at most 40% of cases of multiple physical symptoms.