情绪应激和人格特征对飞行人员神经衰弱的临床意义

Clinical significance of emotional irritability and personality structure for diagnosis of neurasthenia in pilots.

目的探讨情绪应激和人格特征对飞行人员神经衰弱患者的影响及其临床意义。方法飞行人员１０１例，分为对照、病例两组，采用“病例－对照”研究方法，采用症状自评量表，明尼苏达多相个性调查问卷和卡特尔１６种人格因素测量问卷等心理学测量方法。数据分析采用ＯＲ、χ２和多因素拟合条件Ｌｏｇｉｓｔｉｃ回归分析曲线模型等统计学指标。结果病例组：①有明显情绪应激因素存在，最为突出的是躯体化症状、抑郁症状、焦虑症状和精神病质等；②与对照组相比，具有明显的内向人格特征；③条件Ｌｏｇｉｓｔｉｃ回归分析提示，个体的人格结构和情绪应激等心理因素与疾病有密切的相关关系。结论心理学检查和评定，有助于神经衰弱的诊断、鉴别诊断和针对性的治疗；具有特征性“神经症人格结构”的个体是飞行环境下神经衰弱的易感人群之一，应采取必要的防护措施；应尽快建立在岗飞行人员的心理素质考评制度，加强对病态心理倾向者的筛选。

Objective To explore the clinical significance of emotional irritability(EI) and personality structure (PS) for diagnosis of neurasthenia in pilots. Methods SCL 90, MMPI and 16 PF were used to measure EI and PS in 52 pilots with neurasthenia (patient group) and 49 healthy pilots (control group). OR value, χ 2 value, and conditional logistic regression were used for statistic analysis. Results ①Emotional irritability of patient group differed from that of control group, especially in terms of somatization, depression, anxiety and psycoticism. ②A dominant distribution of introversion structure was found in patient group. ③A close relationship between personality structure and pilots with neurasthenia were demonstrated by conditional logistic regression. Conclusion Psychological measurements are helpful for diagnosis of neurasthenia in pilots. It is suggested that psychological measurement should be used in screening of cadets for excluding those with special personality structure susceptible to development of neurasthenia in flight environment.