The prevalence and co-morbidity of subthreshold psychiatric conditions
The prevalence and co-morbidity of subthreshold psychiatric conditions
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DOI：
10.1017/s0033291703001466
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发表时间：
2004-05-01
影响因子：
6.9
通讯作者：
Klein, DN
中科院分区：
文献类型：
--
作者：
Lewinsohn, PM;Shankman, SA;Klein, DN
背景。在以往对阈下疾病的研究中，合并症在很大程度上被忽视了。目的是研究dsm - iv中主要非精神病性障碍的阈下障碍之间以及阈下和全综合征障碍之间的共发病率。参与者来自俄勒冈州青少年抑郁症项目（平均年龄16-6岁，女性占52.1%）。在诊断访谈（K-SADS）的基础上，参与者被分配到8种阈下障碍（重度抑郁症，双相情感障碍，饮食，焦虑，酒精使用，物质使用，行为，多动症）。在分析的1704名青少年中，52.5%至少有一种阈下障碍。其中，40.0%的患者经历过一次阈下共病，29.9%的患者有第二次阈下共病。在阈以下的患者中，36.4%的人也有完全综合征。外化障碍的阈下形式彼此共病。正如预期的那样，阈下焦虑与阈下重度抑郁症共病，但阈下焦虑也与阈下酒精、行为和多动症共病。男性和女性的合并症模式几乎相同。外化障碍会与其他外化障碍共病以及内化障碍会与其他内化障碍共病的假设得到了部分支持。阈下疾病之间以及阈下疾病与完全综合征之间的合并症应该影响未来的研究和临床实践。阈下疾病的评估需要包括其他阈下和全综合征条件的评估。
Background. In previous studies of subthreshold conditions, co-morbidity has been largely ignored. The purpose was to examine rates of co-morbidity among subthreshold disorders and between subthreshold and full-syndrome disorders for the major non-psychotic classes of disorders from DSM-IV.Method. Participants came from the Oregon Adolescent Depression Project (mean age = 16-6 years; females = 52.1%). On the basis of a diagnostic interview (K-SADS), participants were assigned to eight subthreshold disorders (MDD, bipolar, eating, anxiety, alcohol use, substance use, conduct, ADHD).Results. Of the 1704 adolescents in the analyses, 52.5% had at least one subthreshood disorder. Of those, 40.0% had also experienced a co-morbid Subthreshold condition, and 29.9% of those had a second co-morbid subthreshold condition. Of those with a subthreshold, 36.4% also had a full syndrome. The Subthreshold forms of externalizing disorders were co-morbid with each other. As expected, subthreshold anxiety was co-morbid with Subthreshold MDD but subthreshold anxiety was also co-morbid with subthreshold alcohol, conduct, and ADHD. The pattern of co-morbidities was nearly identical for males and females.Conclusions. The hypotheses that externalizing disorders Would be co-morbid with other externalizing disorders and that internalizing disorders would be co-morbid with other internalizing disorders was partially supported. Co-morbidities between Subthreshold disorders and between Subthreshold disorders and full syndrome should impact future research and clinical practice. The assessment of subthreshold disorders needs to include the assessment of other subthreshold and full-syndrome conditions.