双相抑郁和单纯抑郁症患者儿童期受虐及应对方式的差异分析

Differences in childhood abuse and coping styles between patients with bipolar depression and unipolar depression

目的 研究双相抑郁和单纯抑郁症患者儿童期受虐及应对方式的差异。方法 选取安徽医科大学附属心理医院2018年1月至2021年12月收治的100例抑郁症患者,分为单纯抑郁组(n=43)与双相抑郁组(n=57)。记录患者年龄、受教育年限、婚姻状况、家族史等一般资料,比较2组患者躯体快感缺失问卷(RPAS-C)、社会快感缺失量表(RSAS-C)、功能失调性态度问卷(DAS)、儿童期受虐经历问卷(CTQ-SF)和应对方式量表(CSQ)评分。结果 单纯抑郁组RPAS-C、RSAS-C评分显著低于双相抑郁组,差异有统计学意义(P<0.05);2组患者DAS量表中脆弱性、吸引和排斥、寻求赞许评分比较差异无统计学意义(P>0.05);单纯抑郁组完美化、强制性、依赖性、自主性态度、认知哲学及总分评分显著低于双相抑郁组,差异有统计学意义(P<0.05);2组患者CTQ-SF量表中情感忽视(EN)、躯体忽视(PN)评分比较差异无统计学意义(P>0.05);单纯抑郁组情感虐待(EA)、躯体虐待(PA)、性虐待(SA)及总分评分显著低于双相抑郁组,差异有统计学意义(P<0.05);2组患者幻想评分比较差异无统计学意义(P>0.05);单纯抑郁组退避、自责评分显著低于双相抑郁组,求助、合理化、解决问题评分显著高于双相抑郁组,差异有统计学意义(P<0.05)。结论 与单纯抑郁患者相比,双相抑郁患者儿童期虐待经历可能更多、躯体及社会快感缺失程度更为严重,深层认知结构及应对行为均存在较为严重的问题。

Objective To explore the differences in childhood abuse and coping styles between patients with bipolar depression and unipolar depression.Methods A total of 100 patients with depression admitted to the Affiliated Psychological Hospital of Anhui Medical University from January 2018 to December 2021 were selected and divided into unipolar depression group(n=43)and bipolar depression group(n=57).General information such as patients’age,education years,marital status and family history were investigated and recorded.The scores on the somatic pleasure deficit questionnaire(RPAS⁃C),social pleasure deficit scale(RSAS⁃C),dysfunctional attitudes questionnaire(DAS),childhood experiences of abuse questionnaire(CTQ⁃SF)and coping style scale(CSQ)were compared between the two groups.Results RPAS⁃C and RSAS⁃C scores in unipolar depression group were significantly lower than those in bipolar depression group(P<0.05).There were no significant differences in the scores of vulnerability,attraction,rejection or approval seeking in DAS between two groups(P>0.05).The scores of optimization,compulsion,dependence,autonomous attitude,and cognitive philosophy as well as the total score in the unipolar depression group were significantly lower than those in the bipolar depression group(P<0.05).There were no significant differences in the scores of emotional neglect(EN)or physical neglect(PN)in CTQ⁃SF between the two groups(P>0.05).The emotional abuse(EA),physical abuse(PA)and sexual abuse(SA)scores as well as the total score in the unipolar depression group were significantly lower than those in the bipolar depression group(P<0.05).There was no significant difference in fantasy score between the two groups(P>0.05).The scores of withdrawal and self⁃reproach in the unipolar depression group were significantly lower than those in the bipolar depression group,while the scores of seeking help,rationalization and problem solving in the unipolar depression group were significantly higher than those in the bipolar depression group(P<0.05).Conclusion Compared with patients with unipolar depression,patients with bipolar depression may have more childhood abuse experiences,more severe somatic and social pleasure deficits,and more serious problems in deep cognitive structures and coping behaviors.