强迫症患者儿童期创伤及临床特征对其防御方式的影响

Influence of childhood trauma and clinical characteristics on defense style of patients with obsesive-compulsive disorder

目的:探讨强迫症患者儿童期创伤及临床特征对其防御方式的影响。方法:入组107例强迫症患者(强迫症组)及72名健康对照者(健康对照组),进行Yale-Brown强迫量表(Y-BOCS)、儿童期创伤问卷(CTQ)、防御方式问卷(DSQ)等量表的评估。采用多元线性回归分析评估强迫症患者儿童期创伤及临床特征对其防御方式的影响。结果:强迫症组CTQ总分和躯体虐待、躯体忽视因子分显著高于健康对照组(P<0.05或P<0.01)。与健康对照组相比,强迫症组更多地使用不成熟防御机制及中间型防御机制(P<0.05或P<0.01);较少使用成熟防御机制(P<0.01)。强迫症患者的不成熟防御机制受情感虐待因子、Y-BOCS总分和病程的共同影响(B=0.096,P=0.000;B=0.041,P=0.032;B=0.027,P=0.038);中间型防御机制受躯体忽视因子的影响(B=0.066,P=0.009)。结论:强迫症患者的儿童创伤经历、强迫症状的严重程度和病程是影响其防御方式形成的重要因素。

Objective:To explore the influence of childhood trauma and clinical characteristics on defense style of patients with obsessive-compulsive disorder.Method:107 patients with obsessive-compulsive disorder(obsessive-compulsive disorder group)and 72 healthy controls(healthy control group)were recruited.The research data were collected using Yale-Brown Obsessive-Compulsive Scale(Y-BOCS),Childhood Trauma Questionnaire(CTQ)and Defense Style Questionnaire(DSQ).Multiple linear regression analysis was used to evaluate the influence of childhood trauma and clinical characteristics on defense style of patients with obsessive-compulsive disorder.Results:The total scores of CTQ,the scores of physical abuse and the scores of physical neglect in the obsessive-compulsive disorder group were significantly higher than those in the healthy control group(P<0.05 or P<0.01).Compared with the healthy control group,the obsessive-compulsive disorder group preferred to use immature defense mechanisms and intermediate defense mechanisms(P<0.05 or P<0.01)instead of mature mechanisms(P<0.01).The immature defense mechanism of patients with obsessive-compulsive disorder was influenced by the emotional abuse,Y-BOCS total score and the course of illness(B=0.096,P=0.000;B=0.041,P=0.032;B=0.027,P=0.038).The intermediate defense mechanism was influenced by the scores of physical neglect(B=0.066,P=0.009).Conclusion:The childhood trauma experience,the severity of obsessive-compulsive symptoms and the course of illness are important factors affecting the formation of defense style in patients with obsessive-compulsive disorder.