Latent subtypes of manic or irritable episode symptoms in two population-based cohorts
Latent subtypes of manic or irritable episode symptoms in two population-based cohorts
复制标题
两个基于人群的队列中躁狂或烦躁发作症状的潜在亚型
DOI：
10.1101/2021.04.14.21255394
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Arathimos R
中科院分区：
文献类型：
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作者：
Arathimos R
背景：心境障碍的特征是明显的症状异质性，这对临床实践和研究都是一个巨大的挑战。识别具有跨越当前诊断类别的相同症状特征的个体亚组可以提供对个体症状的跨诊断相关性的洞察，而目前的分类诊断系统无法提供这一点。旨在识别具有相同临床特征的人群，使用躁狂和/或易怒情绪的症状，并探索不同人群在诊断、功能结果和遗传易感性方面的差异。方法对英国BIOBANK和PROTECT研究中的8种躁狂和易怒情绪的二元自述症状进行潜伏类分析，探讨个体如何形成潜在性亚群。我们测试了潜伏期与精神疾病诊断、社会人口学特征和多基因风险评分之间的关联。结果在UK Biobank数据库中发现了5个潜在类别(N=42 183)，并在独立保护队列中复制(N=4445)，包括“轻微影响”、“不活跃的不安”、“活跃的不安”、“专注的创造性”和“广泛影响的”个体。这些类别在疾病风险、多基因风险评分和功能结果方面存在差异。其中一组经历了以易怒情绪为主的颠覆性发作，主要是抑郁/焦虑，而自信/创造力增强的一组人报告的颠覆性和功能损害相对较低。结论研究结果表明，包括亚诊断阈值条件在内的精神病理症状的数据驱动调查可以补充临床诊断研究。改进的精神病理学分类系统可以研究对症状的加权方法，朝着对情绪障碍进行更多维度的分类。
Background Mood disorders are characterised by pronounced symptom heterogeneity, which presents a substantial challenge both to clinical practice and research. Identification of subgroups of individuals with homogeneous symptom profiles that cut across current diagnostic categories could provide insights in to the transdiagnostic relevance of individual symptoms, which current categorical diagnostic systems cannot impart. Aims To identify groups of people with homogeneous clinical characteristics, using symptoms of manic and/or irritable mood, and explore differences between groups in diagnoses, functional outcomes and genetic liability. Method We used latent class analysis on eight binary self-reported symptoms of manic and irritable mood in the UK Biobank and PROTECT studies, to investigate how individuals formed latent subgroups. We tested associations between the latent classes and diagnoses of psychiatric disorders, sociodemographic characteristics and polygenic risk scores. Results Five latent classes were derived in UK Biobank (N = 42 183) and were replicated in the independent PROTECT cohort (N = 4445), including ‘minimally affected’, ‘inactive restless’, active restless’, ‘focused creative’ and ‘extensively affected’ individuals. These classes differed in disorder risk, polygenic risk score and functional outcomes. One class that experienced disruptive episodes of mostly irritable mood largely comprised cases of depression/anxiety, and a class of individuals with increased confidence/creativity reported comparatively lower disruptiveness and functional impairment. Conclusions Findings suggest that data-driven investigations of psychopathological symptoms that include sub-diagnostic threshold conditions can complement research of clinical diagnoses. Improved classification systems of psychopathology could investigate a weighted approach to symptoms, toward a more dimensional classification of mood disorders.