躯体化症状为主抑郁症患者的述情障碍

A comparative study of alexithymia of depressive patients characterized by somatic symptoms

目的:探讨以躯体化症状为主抑郁症患者和以情绪症状为主抑郁症患者述情障碍的差异。方法:50例以躯体化症状为主抑郁症患者(躯体症状组)、50例以情绪症状为主抑郁症患者(情绪症状组)和50名正常健康者(正常对照组)参加研究,采用90项症状自评量表(SCL-90)、汉密尔顿抑郁量表(HAMD)和多伦多述情障碍量表进行评定。结果:躯体症状组SCL-90总分、躯体化、焦虑、人际敏感、恐怖、偏执因子分及HAMD的焦虑/躯体化因子评分均高于情绪症状组(P<0.01或P<0.05),情绪症状组在强迫、抑郁因子评分及HAMD的认知障碍、阻滞、日夜变化、睡眠障碍及绝望因子分高于躯体症状组(P<0.05或P<0.01)。躯体症状组与情绪症状组仅在述情障碍因子II评分差异有统计学意义(P<0.05),而在述情障碍总分及因子分上均高于正常对照组(P<0.05或P<0.001)。结论:以躯体化症状为主和以情绪症状为主抑郁症患者均存在述情障碍,以前者更缺乏识别情绪和躯体感受能力。

Objective： To explore the difference of alexithymia between depressive patients characterized by somatic symptoms and depressive patients characterized by mood symptoms. Method：50 depressive pa- tients characterized by somatic symptoms （somatization symptoms group）, 50 ones by mood symptoms （mood symptoms group） and 50 normal controls （ normal group） were enrolled ; assessment were conducted with Toronto alexithymia scale （TAS-26） ,90 symptoms self-reporting inventory （SCL-90） and Hamihon rating scale for de- pression （HAMD） ;the results were compared and analyzed. Results：Somatization symptoms group have morehigher average results on the total scores and the factors scores of somatization, anxiety, human being comunica- tion sensitive, phobophobia, paranoid of the SCL-90, on the sorces of anxiety/somatizatuon of the HAMD than mood symptoms group （P 〈 0.01 or P 〈 0.05） ;mood symptoms group have more higher average results on the scores of obsession, depression of the SCL-90 and cognitive handicap, thought stoppage, day and night change, somnipathy,feeling of despair of the HAMD than somatization symptoms group （P 〈 0.05 or P 〈 0.01 ） ;there were significant differeces in the II factors scores of the TAS-26 between somatization symptoms group and mood symptoms group （ P 〈 0.05 ）, and the two groups have more higher average results than normal group in he total scores or the other factors scores of TAS-26 （P 〈 0.05 or P 〈 0. 001 ）. Conclusion： Depressive patients char- acterized by somatic symptoms and depressive patients characterized by mood symptoms have heavy alexithymia, depressive patients characterized by somatic symptoms tend to have more difficuty recognizing emotion and so- matic feeling.