Multimorbidity of psychiatric disorders as an indicator of clinical severity
Multimorbidity of psychiatric disorders as an indicator of clinical severity
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DOI：
10.1007/s00406-002-0357-6
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发表时间：
2002-08-01
影响因子：
4.7
通讯作者：
Merikangas, KR
中科院分区：
文献类型：
--
作者：
Angst, J;Sellaro, R;Merikangas, KR
本研究探讨了在目前的精神病诊断系统的非层次描述性分类方法产生的高频率的多个诊断的临床和研究意义。来自一般社区的年轻人的15年前瞻性队列研究的数据被用来评估多种疾病的频率（即，多发性精神障碍），以及多种精神障碍的模式与精神病理学严重程度指标相关的程度。在这个以社区为基础的样本中，终身疾病的平均数量为2.1，范围从0到7。诊断光谱内的关联比诊断光谱之间的关联更常见。结果证实了先前几项研究中证实的合并症与严重程度之间的联系，并进一步表明，受试者在15年内符合标准的疾病数量几乎直接增加了所有严重程度指标。每一个主要的诊断类别，特别是抑郁症，有助于增加的严重程度，而不是代表一个非特异性的影响，疾病的数量。这些发现表明了表征多种综合征的重要性，而不是在诊断类别之间应用任意的等级区分。
The present study examines the clinical and research significance of the high frequency of multiple diagnoses emanating from the non-hierarchical descriptive approach to classification in the current psychiatric diagnostic systems. Data from a 15-year prospective cohort study of young adults from the general community were employed to evaluate the frequency of multiple disorders (i.e., multimorbidity), and the extent to which patterns of multiple disorders are associated with indicators of severity of psychopathology. The average number of lifetime disorders in this community-based sample was 2.1 with a range from 0 to 7. Associations within diagnostic spectra were more common than those between diagnostic spectra. The results confirm the link between comorbidity and severity demonstrated in several previous studies and further show that there is a direct increase in nearly all of the indicators of severity by the number of disorders for which the subjects met criteria across 15 years. Each of the major diagnostic categories, particularly depression, contributed to increased severity rather than representing a non-specific effect of the number of disorders. These findings demonstrate the importance of characterization of multiple syndromes rather than applying arbitrary hierarchical distinctions between diagnostic categories.