强迫性障碍完美主义心理及防御方式的病例对照研究

A case-control study of perfectionism and defense style in patients with obsessive-compulsive disorder

目的：探讨强迫性障碍患者的完美主义心理特点及其与心理防御机制之间的关系。方法：在本病例对照研究中，选取71名符合ICD一10精神与行为障碍分类中强迫性障碍诊断标准的门诊或住院患者（病例组），及71名按照性别、年龄（±5岁）、受教育程度进行配比的无精神障碍的志愿者（对照组），用中文Frost多维度完美主义问卷（ChineseFrostMultidimensionalPerfectionismScale，CFMPS）、防御方式问卷（DefenseSt），lesQuestionnaire，DSQ）进行调查。结果：病例组的CFMPS总分[（88．5±16．2）vs．（63．0±10．7）]和担心错误[（16．4±6．4）vs．（11．6±4．0）]、行动的疑虑[（14．6±3．6）vs．（8．8±2．7）]、条理性[（23．4±5．3）vs．（17．2±4．1）]、个人标准[（19．6±5．1）vs．（14．8±3．7）]、父母期望[（14．5±5．0）vs．（10．7±3．5）]维度分，及DSQ的不成熟防御机制[（4．8±0．6）vs．（3．7±0．6）]、中间型防御机制[（4．9±0．5）vs．（4．2±0．6）]因子分均高于对照组，而DSQ的成熟防御机制因子分低于对照组[（3．8±0．6）vs．（5．7±0．8），P〈0．05]。完美主义总分与不成熟防御机制、中间型防御机制正相关（r=0．58，0．44，P〈0．01），与成熟防御机制负相关（r=-0．58，P〈0．01）。Logistic回归分析显示行动的疑虑是强迫性障碍的危险因素（OR=1．46；95％CI=1．09～1．94）。结论：强迫性障碍患者可能比正常人更追求完美，更多使用不成熟和中间型防御机制。

Objective： To explore perfectionism and defense style of patients with obsessive-compulsive disorder and their relationship. Methods： A case-control study was implemented. Seventy-one inpatients or outpatients who met ICD-10 criteria for obsessive-compulsive disorder and 71 controls without mental disorder were recruited, matched by gender, age （ ± 5 }, and education background. The Chinese Frost Multidimensional Perfectionism Scale （ CFMPS ） and Defense Style Questionnaire （ DSQ ） were self-reported by the subjects. Results： The case group got higher scores in total score of CFMPS [ （ 88. 5 ~ 16. 2 ） vs. （63.0 ±10. 7 ） ], concern over mistakes [ （16.4±6.4） vs. （11.6 ±4.0）], doubts about actions [ {14.6_＋3.6） vs. （8.8 ±2.7）], organization [ {23.4±5.3）vs. {17.2±4.1）], personalstandards [ （19.6±5.1）vs. （14.8±3.7）], parentalexpectations [ （14.5±5.0） vs. {10.7±3.5）], immature defense mechanism [ {4.8±0.6） vs. （3.7±0.6）], neurotic defense mechanism [ （ 4. 9 ± 0. 5 ） vs. （4. 2 ± 0.6 ） ] than the control group { Ps 〈 0.05 ） . The case group got lower scores in mature defense mechanism than the control groups [ （ 3.8± 0. 6 ） vs. （ 5.7 ± 0. 8 ）, P 〈 0. 05 ]. The total scores of CFMPS were positively correlated with immature and neurotic defense mechanism （ r = 0. 58, 0. 44, P〈 0. 01 ） and negatively correlated with mature defense mechanism （ r = - 0. 58, P 〈 0. 0 ） . Using conditional lo- gistic regression analysis, the potential risk factor was doubts about actions （ OR = 1.46 ; 95 % CI ： 1.09 - 1.94 ）. Conclusion： Compared to normal people, the patients with obsessive-compulsive disorder may desire to achieve higher standards of performance and make excessive use of the mechanisms of neurotic and immature defense.