PDF(Pubmed)
Abstract：
Traditional clinical diagnoses relying on symptoms may overlook latent factors that illuminate mechanisms and potentially guide treatment. The Operationalized Psychodynamic Diagnosis (OPD) system may compensate for symptom-based diagnosis by measuring psychodynamic profiles underlying mental disorders through conflicts and structure axes. However, OPD has not been widely adopted in China, and it remains unclear whether OPD can be used as an effective approach to distinguish between depression and anxiety. The current study aims to adopt the OPD system to investigate the psychodynamic profiles of major depressive disorder (MDD) and generalized anxiety disorder (GAD) in China, targeting patients with \"pure\" symptoms without comorbidity. We recruited 42 MDD patients, 32 GAD patients, and 31 healthy controls (HC), and assessed their self-report depression and anxiety symptoms, along with their underlying psychodynamic profiles through OPD interviews. Overall, both MDD and GAD patients showed more prominent conflict issues and lower levels of structure than HC. The MDD and GAD groups yielded different conflict profiles and conflict processing modes when processing their second conflicts. Importantly, the multi-dimensional psychodynamic profiles achieved machine learning classification of clinical groups with an accuracy of 0.84, supporting successful distinction of MDD and GAD patients. In conclusion, the OPD demonstrated sensitivity in revealing distinct psychodynamic profiles underlying \"pure\" depression and anxiety clinical populations in China. This work calls for future incorporation of OPD as a tool to investigate psychodynamic formulations underlying mental disorders, compensating for traditional symptom-based diagnostic approaches to guide precise individualized interventions.
摘要：
依赖症状的传统临床诊断可能忽略了阐明机制并可能指导治疗的潜在因素。可操作的心理动力学诊断（OPD）系统可以通过冲突和结构轴测量潜在精神障碍的心理动力学特征来补偿基于症状的诊断。然而,OPD在中国还没有被广泛采用，目前尚不清楚OPD是否可以作为区分抑郁和焦虑的有效方法。本研究旨在采用OPD系统调查中国重性抑郁障碍(MDD)和广泛性焦虑障碍(GAD)的心理动力学特征,针对无合并症的“纯”症状患者。我们招募了42名MDD患者，32名GAD患者，和31个健康对照（HC），评估他们自我报告的抑郁和焦虑症状，通过OPD采访，以及他们潜在的心理动力学特征。总的来说,与HC相比,MDD和GAD患者均表现出更突出的冲突问题和更低的结构水平.MDD和GAD组在处理其第二个冲突时产生不同的冲突配置文件和冲突处理模式。重要的是,多维心理动力学谱实现了临床组的机器学习分类,准确率为0.84,支持MDD和GAD患者的成功区分.总之,OPD在揭示中国“纯”抑郁和焦虑临床人群潜在的不同心理动力学特征方面表现出敏感性。这项工作要求将来将OPD纳入研究精神障碍的心理动力学配方的工具，补偿传统的基于症状的诊断方法，以指导精确的个性化干预。
