是否知道病情真相及其应对方式对乳腺癌妇女人格和精神障碍的影响

Effects of awareness of the nature of the illness and its coping stlye on personality and mental disorder in breast cancer women

目的:研究乳腺癌患者是否知道自己所患疾病真相、对治疗的信心与期望及其应对方式等因素对人格和精神障碍影响。方法:乳腺癌妇女精神心理状态和人格评定采用临床晤谈、MMPI人格问卷和生活事件量表及基本情况问卷的方法,以SPSS10.0软件进行统计学处理。结果:①208例年龄为24～83岁乳腺癌妇女,MMPI测量结果高于70分的临床量表:疑病(Hs)为40.9%,抑郁(D)为72.6%,癔症(Hy)为38.5%,偏执(Pd)为17.8%;男女性能度(Mf)高于60分占50.0%,但都低于70分;妄想(Pa)和精神衰弱(Pt)分别有42.8%和54.8%高于70分,精神分裂(Sc)为76.9%,躁狂(Ma)为17.8%,而7例(3.4%)社会内向(Si)高于70分,58.6%高于60分。②多因素Logistic分析发现,知道自己所患癌症诊断真相和疾病的性质使Pa(OR=3.79,P=0.003)、Pt(OR=3.85,P=0.01)、Sc(OR=14.6,P=0.00001)量表分值增高,心理社会调节能力差,而对MMPI测量值其他量表没有影响。结论:知道癌症诊断真相和疾病的性质是Pa,Pt和Sc量表增高的重要危险因素;不知道疾病真相的乳癌妇女心理调节和社会责任能力良好,不支持径告患者癌症真相。

AIM:To study the effects of awareness of the nature of the illness and confidence and expectations of the outcome on the personality and mental disorder of patients with breast cancer. METHODS:Clinical interview,Minnesota multiphasic personality inventory(MMPI),questionnaires on life event and basic data were used to assess mental status and personality assessment of the women with breast cancer.SPSS 10.0 software was used for statistical analysis. RESULTS:①Among 208 patients,aged from 24 to 83 years,the MMPI results showed that there were 40.9%of the cases for hypochondriasis(Hs),72.6%for depression(D),38.5%for hysteria(Hy) and 17.8%for psychopathic devite(Pd);50%with the score of masculinity femininity(Mf)≥60,but≤70;42.8%and 54.8%with the scores of both paranoia(Pa) and psychasthenia(Pt)≥70,76.9%for schizophrenia(Sc),17.8%for hypomania(Ma);Only 3.3%(7 women) and 58.6%for social introversion(Si) with the scores ≥70 and ≥60 respectively.②Multiple logistic regression showed that the awereness of nature of the illness made the scores of MMPI for Pa(OR=3.79,P=0.003),Pt(OR=3.85,P=0.01) and Sc(OR=14.6,P=0.000 01) higher,made psychological ablity of social adjustment worse,while had no correlation with the other scores of MMPI. CONCLUSION:Awareness of nature of the illness is the improtant risk factor for developing levels of Pa,Pt and Sc.The patients with breast cancer who are unaware of the truths of the diseases have good psychosocial adjustment and social duty and ability.So it is better not to tell patients the truth of their diseases.