神经性厌食患者的人格特征及焦虑抑郁症状

Personality characteristics and depression and anxiety symptoms in patients with anorexia nervosa

目的:探讨神经性厌食患者的人格特征及焦虑抑郁症状,为临床治疗和疾病预防提供参考依据。方法:选取94例同时符合中国精神障碍分类与诊断标准第3版(CCMD-3)和美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)诊断标准的神经性厌食患者,其中限食型41例,暴食/清除型53例;选取72例某精神专科医院实习护士为对照组。两组均采用明尼苏达多项人格(MMPI)、汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)进行测查。结果:病例组抑郁症状(85.1%vs.8.3%)和焦虑症状(75.5%vs.2.8%)的检出率高于对照组(均P<0.05)。病例组M M PI测试结果除男子-女子气、说谎量表、诈病量表、校正量表的T分与对照组无统计学差异外(均P>0.05),精神病态、抑郁、癔病、疑病、偏执、精神衰弱、精神分裂症、轻躁狂及社会内向的T分均高于对照组(均P<0.05);T分最高的量表分为精神病态(Pd)(63.8±11.2),其次是抑郁(D)(61.0±12.8),两点编码呈现24/42编码。暴食/清除型患者的疑病(Hs)的T分高于限食型[(53.3±9.9)vs.(58.7±9.3),P<0.05]。结论:神经性厌食患者有其特定的人格特征,尤其是精神病态和抑郁更为突出。

Objective： To study the personality characteristics associated with anorexia nervosa, to provide a reference for the clinical treatment and disease prevention. Methods： Totally 94 cases from meeting the Chinese Classification and Diagnostic Criteria of Mental Disease, Third Edition （CCMD-3） and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition （DSM-IV） for anorexia nervosa were selected, including 41 cases of the restricting type and 53 cases of the binge-eating/purging type. Seventy-two student nurses in a psychiatric hospi- tal were selected as the control group. Both groups were assessed with the Minnesota Multiphasic Personality Inventory （MMPI）, Hamilton Rating Scale for Depression （HAMD）, and Hamilton Rating Scale for Anxiety （HAMA）. Results： The rates of depression （85. 1% vs. 8. 3% ） and anxiety （75.5% vs. 2. 8% ） were higher in the case group than in the control group （Ps 〈 0. 05）. There was no significant difference in the scores of MMPI four subscales of ＂masculinity-femininity＂, ＂lie＂, ＂infrequency＂, ＂correction＂ between the case group and the control group （Ps 〉 0. 05）. The T scores of the MMPI subscales of ＂psychopathic deviate＂, ＂hysteria＂, ＂hypochondriasis＂, ＂paranoia＂, ＂ psychasthenia＂, ＂schizophrenia＂,＂hypomania＂ and ＂social introversion＂ were higher in the case group than in the control group （Ps 〈 0.05）, and the T scores of ＂psychopathic deviate＂ （63.8 ± 11.2） was the highest, and ＂depression＂ （61.0 ± 12. 8） was the second, analysis of coded map showed the type of 24/42. The T score of ＂hypochon- driasis＂ was higher in the binge-eating/purging type than in the restricting type [ （58. 7 ± 9. 3） vs. （53.3 ± 9. 9）, P 〈 0. 05） ]. Conclusion： It suggests that the patients with anorexia nervosa may have specific personality traits, especially psychopathic deviate and depression.