基于SCL-90分析心理性和器质性勃起功能障碍患者心理特征差异

Analysis of psychological characteristics differences of patients with psychogenic and organic erectile dysfunction based on symptom checklist 90

目的应用90项症状自评量表(SCL-90)比较心理性和器质性勃起功能障碍(ED)患者心理特征差异,并寻找和心理因素相关的鉴别诊断心理性ED的因子。方法回顾性选取2019年3月至2020年7月江苏省中医院男科诊治的202例ED患者作为研究对象。根据海绵体活性药物注射(ICI)+阴茎彩色多普勒超声(PCDU)和夜间勃起试验结果,将患者细分为心理性ED组(n=86)和器质性ED组(n=116)。将所有患者SCL-90各因子分与全国常模结果进行t检验。对心理性ED组和器质性ED组SCL-90各因子分和阳性率分别进行t检验和χ^(2)检验,筛选出有统计差异的因子进一步行Logistic回归分析。采用受试者工作特征(ROC)曲线评估差异因子诊断心理性ED的效能。结果与全国常模比较,ED患者SCL-90各因子分均有显著升高(P<0.001)。与器质性ED相比,心理性ED在抑郁、躯体化、偏执、恐怖这4类因子中分数显著升高(P<0.01)。将上述4类有统计学差异的因子纳入Logistic回归分析发现,抑郁因子具有统计学意义,抑郁因子诊断心理性ED的曲线下面积(AUC)为0.70。结论ED患者存在异常心理因素,心理性ED患者较器质性ED心理问题更为突出,SCL-90抑郁因子对区分心理性和器质性ED有潜在应用价值。

Objective To compare the psychological characteristics differences of patients with psychogenic and organic erectile dysfunction(ED)using symptom checklist 90(SCL-90),and to explore differential diagnostic indicators related to psychological factors for psychogenic ED.Methods From March 2019 to July 2020,a total of 202 ED patients were selected as study subjects.The patients were divided into psychogenic group(n=86)and organic group(n=116)according to the results of intracavernous injection(ICI),penile color Doppler ultrasound(PCDU)and nocturnal penile tumescence and rigidity(NPTR).The factors scores of SCL-90 of all patients were compared with national norm results by t tests.The differences of factors scores and positive rates of SCL-90 between psychogenic group and organic group were compared by t test andχ~2 tests,respectively.The factors with statistical differences were furthermore analyzed by Logistic regression.The receiver operator characteristic(ROC)curve was used to evaluate the efficacy of difference factors in diagnosing psychological ED.Results Compared with the national norm,the factors scores of SCL-90 increased significantly in ED patients(P0.001).Compared with the organic ED group,the scores of depression,somatization,paranoid and phobia increased significantly(P0.01).Logistic regression analysis of the above four types of factors with statistical differences showed that depression factor had significant difference.The area under the ROC curve(AUC)of depression factor in diagnosing psychogenic ED was 0.70.Conclusions ED patients have abnormal psychological factors,and psychogenic ED patients showed more prominent psychological problems than organic ED patients.The depression factor of SCL-90 exhibited potential application value in the distinction of psychogenic and organic ED.