惊恐发作患者心理健康水平及人格特征的评估

Psychosomatic symptoms and personality in patients with panic attack

目的:探讨惊恐发作患者的心理健康水平及其人格特征。方法:2001-10/2004-10选择沈阳军区总医院门诊部依据美国精神病学会出版的《精神障碍及统计手册》第4版(DSM-IV)诊断标准确诊的惊恐发作患者189例为研究组,和随机抽样选出的无明显心身疾患的健康大学生189例为对照组,进行心理健康水平及人格特征评估。以临床症状自评量表(SCL-90)各症状因子分评定心理健康水平,各症状因子分≥2为有中度心理问题,≥3为有重度心理问题。以艾森克个性问卷(EPQ)判定人格特质,各维度因子评分≤38.5或≥61.5为分界值,并做PEN模型评估。结果:研究组患者中度心理问题发生范围是45.5%～86.2%,重度心理问题发生范围是11.1%～40.7%,以焦虑、强迫、躯体化、抑郁、恐怖等症状为主。对照组心理问题以人际关系敏感和强迫观念为主,发生范围9.0%～37.6%。惊恐发作患者心理健康水平明显低于对照组(P<0.01)。研究组人格特征中代表精神质(P)、内外向(E)和神经质(N)的PEN模型呈现V字形,神经质分极高者60.2%,内外向分极低者22.1%,精神质分极高者17.1%,而对照组神经质分极高者13.2%,内外向分极低者2.6%,精神质分极高4.2%,两组比较χ2=-9.2,-5.9,-4.8,P<0.01。研究组以严重神经质,极端内向和精神质表现为主。结论:惊恐发作患者心理健康水平很?

AIM:To investigate the mental health level and personality characteristics of patients with panic attack. METHODS:Evaluation on the mental health level and personality characteristics was performed in 189 patients (study group),who were diagnosed to have panic att ack according to the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM IV) in the outpatient department of Chin ese PLA General Hospital of Shenyang Military Area Command during October 2001 a nd October 2004,and 189 healthy university students (control group) without obvi ous psychosomatic diseases,who were randomly selected. Mental health level was a ssessed by the factor scores of symptom checklist 90 (SCL 90),the score of eac h symptom ≥2 and 3 was considered to have moderate and severe psychological pro blems respectively.The personality characteristics were evaluated with the Eysen ck personality questionnaire (EPQ),the value of delimitation of each dimension w as ≤38.5 or ≥61.5,and the evaluation of PEN model, which stood for psychoticis m (P), extroversion introversion (E) and neuroticism (N), was performed. RESULTS:In the study group, the occurrence range of moderate psychological pro blems was 45.5%to 86.2%, and that of severe psychological problems was 11.1%t o 40.7%,and the main symptoms were anxiety, obsession compulsion,somatization, depression and phobic anxiety. The psychological problems in the control group w ere interpersonal sensitivity and obsession compulsion, and the occurrence rang e was 9.0%to 37.6%. The mental health level was obviously lower in the patient s with panic attack than in the control group (P< 0.01). In the study group, the PEN model showed the shape of 'V', 60.2%of the patients had the highest N scor e, 22.1%had the lowest E score, and 17.1%had the highest P score, significantl y different from those in the control group (13.2%, 2.6%, 4.2%) (χ2=-9.2, -5.9,-4.8,P< 0.01). There were severe neuroticism, extremity introversion an d psychoticism in the study group. CONCLUSION: The mental health level of patients with panic attack is very low, and they have the personality characteristics of extremely introversion and psy choticism.