抑郁症患者精神病性症状与童年期虐待及防御方式的关联研究

Research on relationship between childhood abuse and defense styles in major depressive disorder with psychotic symptoms

目的:探讨童年期虐待和防御方式与抑郁症患者精神病性症状的关系。方法:根据是否存在精神病性症状,将160例抑郁症患者分成伴精神病性症状抑郁症组(PMD组,80例)和不伴精神病性症状抑郁症组(NMD组,80例);两组患者均完成一般资料调查表、儿童期虐待问卷(CTQ)和防御方式问卷(DSQ)的评定。结果:两组在情感虐待(F=68.88,P<0.001)、躯体虐待(F=70.91,P<0.001)、性虐待(F=2.91,P=0.007)、情感忽视(F=45.93,P<0.001)和童年虐待总分(F=77.28,P<0.001)差异具有统计学意义;在不成熟防御方式(F=2.98,P=0.006)上差异具有统计学意义;Logistic回归分析显示发病年龄越早(B=2.57,P=0.024)、有童年虐待经历(B=1.95,P=0.003)、不成熟防御方式(B=2.54,P<0.001)、抑郁症状重(B=1.33,P=0.013)的抑郁症患者,伴发精神病性症状风险性大。结论:成熟防御方式可能是抑郁症伴精神病性症状的保护性因素,而不成熟防御方式可能是抑郁症伴精神病性症状危险因素。

Objective:To explore the relationship between childhood abuse and defense styles in major depressive disorder with psychotic symptoms.Method:One hundred and sixty patients with depression were divided into the study group(80 cases,with psychotic symptoms)and the control group(80 cases,without psychotic symptoms).The General Information Questionare(GIQ),the Childhood Trauma Questionnaire(CTQ)and the Defense Style Questionnaire(DSQ)were used for evaluation.Results:There were significantly differences in the emotional abuse(F=68.88,P<0.001),the physical abuse(F=70.91,P<0.001),the sexual abuse(F=2.91,P=0.007),the emotional neglect(F=45.93,P<0.001)and total score of childhood abuse(F=77.28,P<0.001)between the two groups;there were significant differences in the immature defense style(F=2.98,P=0.006);Logistic regression analysis showed that attack in early age(B=2.57,P=0.024),the experience of childhood abuse(B=1.95,P=0.003),the immature defense style(B=2.54,P<0.001),seriously depressive symptoms(B=1.33,P=0.013)may indicate the psychotic symptoms.Conclusion:Mature defense may be a protective factor in major depressive disorder with psychotic and immature defense may be an important risk factor.