阿片相关性障碍的人格特征及伏隔核毁损手术对其的影响(附26例分析)

Influence of nucleus accumbens lesioning on the personality characteristics in patients with opioid-related disorders: analysis of 26 cases

目的观察伏隔核毁损手术对阿片相关性障碍病人的人格影响。方法选择我院手术治疗的男性病人26例,手术前后采用艾森克个性问卷(EPQ)施测,调查3个人格维度[内外向(E)、神经质(N)及精神质(P)]和1个效度量表(L)。结果术前E标准分平均为(55.96±12.89)分,N为(64.81±11.27)分,P为(62.50±8.51)分,L为(40.19±9.85)分;术前、术后粗分与常模比较,E、N、P、L差异有统计学意义。手术前后自身对照分析结果显示:仅N分差异有统计学意义;术后N标准分下降16例,平均下降12.25分。结论手术前病人呈不稳定、偏外向人格。手术矫治了部分病人的病理性心理症状,使EPQ的N分下降,病人不稳定型人格特质改善。手术未使病人外倾、精神质高分、掩饰性偏低等人格特征改变。

Objective To observe the influence of nucleus accumbens surgery on personality characteristics in patients with opioid-related disorders. Methods Twenty-six male patients admitted in our hospital were enrolled, and surveyed with Eysenck Personality Questionnaire （EPQ） in the preoperative and postoperative period. Personality characteristics were evaluated with the three personality dimensions of extroversion introversion （E）, neuroticism （N） and psychoticism （P）, and a validity scale （L）. Results Preoperative average standard score was 55.96±12.89 for E, 64.81±11.27 for N, 62.50±8.51 for P, and 40.19±9.85 for L. There were significant differences in the raw scores orE, N, P and L between the patients and norms. Compared with preoperative scores, 26 patients showed significant difference before and after surgery was found only in N score, and the average standard score of 16 cases with decrease in N reduced 12.25 points. Conclusion Unstable extroversion personality occurs in preoperative patients with opioid-related disorders. Nucleus accumbens surgery can correct the pathological psychological symptoms of the patients, and reduce the N-EPQ score, leading to improvement of the unstable personality traits of patients. But no change is observed in the high scores of extroversion and psychoticism, as well as low score of lie dimension.