The structure of common DSM-IV and ICD-10 mental disorders in the Australian general population
The structure of common DSM-IV and ICD-10 mental disorders in the Australian general population
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DOI：
10.1017/s0033291706008452
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发表时间：
2006-11-01
影响因子：
6.9
通讯作者：
Watson, David
中科院分区：
文献类型：
--
作者：
Slade, Tim;Watson, David
背景常见精神障碍之间的共现模式可以提供有关精神病理学的潜在维度的信息。本研究的目的是确定四种模型中哪一种最适合10种常见的DSM-IV和11种常见的ICD-10精神障碍之间的共现模式。数据来自澳大利亚国家精神健康和幸福调查（NSMHWB），这是一项大规模的精神障碍社区流行病学调查。参与者包括10641名社区志愿者的随机人群样本，代表78%的响应率。DSM-IV和ICD-10精神障碍诊断使用复合国际诊断访谈（CIDI）2.0版获得。采用验证性因素分析（CFA）评价竞争模型的相对拟合度。一个层次的三因素变化的两因素模型表现出最好的拟合精神障碍之间的相关性。该模型包括一个痛苦因素，对重性抑郁症，心境恶劣，广泛性焦虑症（GAD），创伤后应激障碍（PTSD）和神经衰弱（仅ICD-10）具有高负荷;一个恐惧因素，对社交恐惧症，恐慌症，广场恐怖症和强迫症（OCD）具有高负荷;和一个外在因素，对酒精和药物依赖具有高负荷。痛苦和恐惧的因素最好的概念化的子因素的高阶内化因素。有必要更加注重痛苦、恐惧和外部化的基本方面。
Background. Patterns of co-occurrence among the common mental disorders may provide information about underlying dimensions of psychopathology. The aim of the current study was to determine which of four models best fits the pattern of co-occurrence between 10 common DSM-IV and 11 common ICD-10 mental disorders.Method. Data were from the Australian National Survey of Mental Health and Well-Being (NSMHWB), a large-scale community epidemiological survey of mental disorders. Participants consisted of a random population-based sample of 10641 community volunteers, representing a response rate of 78%. DSM-IV and ICD-10 mental disorder diagnoses were obtained using the Composite International Diagnostic Interview (CIDI), version 2.0. Confirmatory factor analysis (CFA) was used to assess the relative fit of competing models.Results. A hierarchical three-factor variation of a two-factor model demonstrated the best fit to the correlations among the mental disorders. This model included a distress factor with high loadings on major depression, dysthymia, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD) and neurasthenia (ICD-10 only); a fear factor with high loadings on social phobia, panic disorder, agoraphobia and obsessive-compulsive disorder (OCD); and an externalizing factor with high loadings on alcohol and drug dependence. The distress and fear factors were best conceptualized as subfactors of a higher order internalizing factor.Conclusions. A greater focus on underlying dimensions of distress, fear and externalization is warranted.