物质依赖创伤后应激障碍患者防御方式分析

Defense styles in drug abusers with post traumatic stress disorder

目的探讨病前有无物质依赖史的创伤后应激障碍(PTSD)患者的临床特征及防御方式的差异性。方法对170例创伤后应激患者以不同性别进行分组,其中物质依赖组85例,非物质依赖组85例。采用半定式检查法,严格按照遗传学研究用诊断检查问卷内容询问入组患者临床症状,应用防御方式问卷(DSQ)、汉密顿抑郁量表(HAMD)、抑郁自评量表(SDS)进行评定分析。结果HAMD评分两组患者总分差异均无显著性(P>0.05),但物质依赖组患者的自杀、激越、精神性焦虑、躯体性焦虑、胃肠道症状及全身症状与非物质依赖组比较有显著性差异(P<0.05)。SDS评分物质依赖组患者心跳加快、疲劳、坐立不安、生活无意义感得分与非物质依赖组比较有显著性差异(P<0.05);DSQ评分创伤后应激患者多采用不成熟型或中间型防御方式来应对生活事件;物质依赖组患者被动攻击、幻想、投射、退缩、躯体化及因子Ⅳ(掩饰)得分与非物质依赖组比较有非常显著性差异。两组患者运用成熟型防御方式差异无显著性(P>0.05)。结论有物质依赖史的PTSD患者临床特征及防御方式与无物质依赖史的患者比较差异性明显。

Objective To explore the defense styles in drug abusers with post traumatic stress disorder. Methods 85 drug abusers and 85 non-drug abusers who affect post traumatic stress. Clinical symtoms were inquired strictily with the DIGS using semi-structured check-up, assessments conducted with the CSQ, the HAMD and the SDS. Results There was no significant difference in total score （ P 〉 0. 05）, and scores of body-anxiety and gastrointestinal symptoms were higher in the drug abuse patients. There were no gender differences in total score and other factor scores （ P 〉 0.05 ）. By the CSQ, scores of passive aggression, retraction and pseudo-benefit others were significantly higher in drug abusers. Conclusion There and differences in the clinical characteristics and defense styles among drug abusers and non-drug abusers with post traumatic stress disorder.