强迫障碍心理社会相关因素的病例对照研究

A Case-Control Study of Psychosocial Factors Related to Obsessive-Compulsive Disorder

目的:探讨与强迫障碍发生相关的心理社会因素。方法:采用1:2病例对照研究,以生活事件量表、特质应对方式量表、家庭亲密度与适应性量表、父母养育方式评价量表对61名强迫障碍患者及按照性别、年龄(±3岁)、受教育程度进行配比的无精神障碍的志愿者122名进行问卷调查。结果:病例组和对照组的负性事件[(40.8±50.6)vs.(13.8±21.4)]、家庭实际亲密度[(61.0±14.0)vs.(66.7±11.3)]及适应性[(39.9±12.0)vs.(47.3±9.5)]、积极应对[(25.7±6.4)vs.(36.0±6.1)]、消极应对[(37.3±5.5)vs.(31.3±5.8)]、父母养育方式[如病例组父亲情感温暖(42.6±12.6),对照组(47.9±10.7)]量表得分差异有统计学意义(均P<0.05)。Logistic回归分析显示强迫障碍发生的保护因素是积极应对(OR=0.14;95%CI:0.06-0.32);危险因素是消极应对(OR=3.74;95%CI:1.30-10.82)及家庭适应性之差(OR=5.97,95%CI 1.61-22.14)。结论:个人应对方式及家庭关系与强迫障碍发生有关联。

Objective： To explore psychosocial factors related to obsessive-compulsive disorder. Methods： A 1：2 case-control study was carried out among 61 patients with obsessive-compulsive disorder and 122 controls without mental disorder, matched by gender, age （±3）, and education background. The Life Event Scale, Trait Coping Style Questionnaire, Family Adaptability and Cohesion Scales second edition, and EMBU were self-reported by the subjects. Results： There were statistical differences （ P 〈 0. 05 ） between case and control groups in negative life event [（40.8±50.6） vs.（13.8±21.4）], realistic cohesion of family [（61.0±14.0） vs. （66.7± 11.3）], realistic adaptability of family [（39.9±12.0） vs.（47.3±9.5）], parental rearing behaviors [e.g.,（42.6±12.6） and （47.9±10.7） regarding lathers＇warmth factor] and personal coping style. By conditional logistic regression analysis, the potential protective factor was positive coping style （ OR = 0. 14 ; 95% CI： 0.06 - 0. 32 ） . The potential risk factors included negative coping style （ OR = 3.74 ; 95% CI： 1.30 - 10. 82 ） and the difference between realistic and ideal family adaptability （OR = 5.97, 95% CI： 1.61-22.14）. Conclusion： Personal coping style and family relationship are likely associated with occurrence of obsessive-compulsive disorder.