摘要
用疾病自评量表(SCL一90),对7l例不同性别、年龄、文化程度、病期、畸残度及有无近亲的麻风病人进行了心理分析,表明麻风病人的总痛苦水平较高,心理反应的总均分为105.549±57.214,SCL—90 lO个月因子水平平均超过2分的都大于5％,较正常人高。畸残程度对病人心理有直接影响,Ⅱ～Ⅲ级畸残病人的SCL—90各因子分较I级畸残者显著增高。无近亲和院内隔离的病人,强迫、抑郁、恐怖性焦虑、偏执观念和精神病的均分,比有近亲和院外治疗者高。病期与SCL—90总分高度相关,病期越长,病人的失落感、恐怖感和敌意感越重。文盲患者的抑郁和恐怖性焦虑,较有小学以上文化者的严重。不同性别、年龄间的SCL—90分无明显差异。分析71例麻风的SCL—90各因子发现,10个因子之间有显著差别,其中最敏感的为人际敏感、抑郁和恐怖性焦虑,较为敏感的为强迫、焦虑和敌意.作者从与病人交谈中了解到,从常人进入麻风病人的角色后,心理反应首先是恐怖性焦虑和躯体化症状,然后是强迫、人际敏感和偏执等症,个别病人变得酗酒、迷信、赌博、有敌意或欲自杀。71例中有过自杀念头的48例(68.6％),有过自杀行为者4例。作者认为,处理麻风病人的心理问题,关键在于:1、争取社会支持,改善治疗环境;2、加强健康教育,消除社会对麻风的恐惧;3、医护人员多与病人交谈,劝慰他们,使其心理达到领悟,消除恐惧和心理障碍;4、早发现、早治疗,预防和减少畸残,以保障病人身心健康。
ABSTRACT The influences of sex, age, educational level, disease duration , disability and having or not close relatives on their mind in 71 patients with leprosy have been analysed by using the dis-ease self-estimate table of SCL-90. The results showed their suffering levels to be higher than those in healthy presons and the total mean score of psychological response was equal to 105. 55 卤57. 21. The degree of disability has made a direct impact on the patient's mind. As compared with the patients living at home, the patients isolated in leprosaria without close relatives have higher scores in compulsion, depression , phobic anxiety,bigoted ideas and psychosis. The longer the disease duration, the more severe the lost and phobic feeling and hostility. The illiterate pa-tients have more serious lost and phobic feeling. According to ten factors in SCL-90,the most sensitive ones are interpersonal sensitivity,depression and phobic anxiety,and the next ones are compulsion, anxiety and hostility. After they firmly believed the diagnosis, a few patients began excessively drinking,became superstitious,gamblesome,hostile and even tending to suicide. Forty eight of the 74 cases had suicide intentions and four commited suicide themselves (without comple-tion). The authors point out that for the psychological health of leprosy patients it will be neces-sary to obtain the support of the public in removing discrimination against the patients through popular health education and to find and treat the patients as early as possible in the interests of prevention of the disability.
