缓解期抑郁症患者述情障碍与认知应对策略关系的初步研究

A primary study on the relationship between alexithymia and cognitive coping strategies for major depression in paracmasis

目的 探讨缓解期抑郁症患者述情障碍与认知应对策略的特征及二者的关系.方法 采用多伦多述情量表（TAS-20）中文版、认知情绪调节问卷中文版（CERQ-C）对130例缓解期抑郁症患者进行评定,并与95例健康志愿者（对照组）比较.结果 （1）抑郁症组TAS-20总分及因子I、III分仍显著高于对照组,依次为（51.00±9.25）分vs（48.04±8.79）分、（16.97±5.46）分vs（15.90±4.26）分、（21.31±4.11）分vs（19.09±3.03）分,P＜0.05或P＜0.01.CERQ-C中责难自己、沉思、积极重新关注、理性分析、责难他人因子分低于对照组,接受、重新关注计划、积极重新评价因子分高于对照组,依次为（10.63±3.21）分vs（12.56±2.26）分、（9.72±3.13）分vs（12.01±2.44）分、（11.08±2.94）分vs（12.11±2.65）分、（8.88±3.07）分vs（11.66±2.41）分、（8.88±3.69）分vs（10.19±2.35）分、（13.26±3.67）分vs（12.56±2.26）分、（13.56±3.56）分vs（12.51±3.65）分、（13.81±4.06）分vs（12.47±3.70）分,P＜0.01;（2）CERQ-C沉思、接受、责难他人等因子依次进入TAS-20总分的回归方程;自杀行为、医疗费用、抑郁总分等因子依次进入TAS-20因子I的回归方程;沉思因子、父母文化程度进入TAS-20因子II的回归方程; 接受、责难他人与积极评价因子等依次进入TAS-20因子III的回归方程.结论 缓解期抑郁症仍存在明显的述情障碍与不良的认知应对策略.述情障碍的不同纬度影响因素不同,不适应性的应对策略可能仍为缓解期抑郁症患者述情障碍重要的影响因素.

Objective To investigate the characteristics of alexithymia and cognitive emotion regulation and the relationship between the two symptoms in major depressive patients in pracmasis. Methods One hundred and thirty major depression patients in paracmasis were assessed with the Chinese version of Cognitive Emotion Regulation Questionnaire （CERQ--C） and the twenty--item Toronto Scale （TAS--20）. Ninty--five healthy people were included as controls. Results Compared with healthy controls, the depression patients showed significantly higher scores in the total score of TAS-20, TAS-20 I and III factor scores （P〈0.05 or P〈0.01）,lower scores in self blame, rumination, positive refocusing, perspective, blaming, and higher scores in acceptance, planning, and reappraisal of CERQ--C （P 0.01）. The CERQ-C factor of rumination,acceptance, and blaming entered the regression equation for total score of TAS--20 in turn. The factor of Suicidal behavior, medical cost and total score of BDI entered the regression equation for TAS--20 I in turn. Rumination and parents/ education years entered the regression equation for TAS--20 II. Acceptance, blaming and reapprasial of CERQ--C entered the regression equation for TAS-- 20 III in turn. Conclusions Major depression in paracmasis still suffered from significant alexithymia and poor cognitive coping strategies. The influential factors contributing to three dimension of alexithymia were different. Poor cognitive coping strategies may be still responsible for alexithymia in major depression patients in paracmasis.