洗涤组、检查组和反刍思维组强迫症患者的心理特征  

Psychological characteristics in obsessive-compulsive patients with different subsyndrome

作　　者：牟艳丽[1] 丛中[1] 李幼辉[2] 连楠[2] 

机构地区：[1]北京大学精神卫生研究所,卫生部精神卫生学重点实验室(北京大学),北京100191 [2]郑州大学第一附属医院,郑州450052

出　　处：《中国心理卫生杂志》2010年第11期823-827,838,共6页Chinese Mental Health Journal

摘　　要：目的：比较洗涤组、检查组、反刍思维组强迫症患者的人格特质、安全感与厌恶感.方法：采用帕多瓦量表-华盛顿州立大学修订版（中文版）、瑞典大学人格量表、安全感量表和中文厌恶感量表对80例符合ICD-10精神与行为障碍分类中强迫障碍诊断标准的住院和门诊病人,以及80例健康志愿者进行测查.根据帕多瓦量表-华盛顿州立大学修订版（中文版）评分将全部病例分为洗涤、检查和反刍思维三组,对测查结果进行方差分析、Kruskal-Wallis H检验和相关分析等统计分析.结果：①洗涤组病例29例,检查组32例,反刍思维组19例;②反刍思维组躯体焦虑和精神焦虑得分[（70.3±11.0）vs.（72.8±9.7）]大于洗涤组[（56.6±11.9）vs.（66.5 ±8.9）]和检查组[（61.4±10.7）vs.（66.2±7.9）],三组均大于健康对照组[（50.5±8.9）vs.（50.8±9.7）,Ps〈0.05];③反刍思维组安全感得分（37.9±7.1）小于洗涤组（47.0±9.5）和检查组（48.5 ±8.9）,三组均小于健康对照组（62.8±11.3）（Ps〈0.05）;④洗涤组厌恶感得分依次大于检查组、反刍思维组和健康对照组[（103.0±9.5）vs.（89.7±11.0）,（85.3±10.8）,（86.2±13.5）,Ps〈0.01];⑤污染/洗涤强迫得分与缺乏自信和社交愿望得分呈负相关（r=-0.23,-0.38）,与冷漠得分、厌恶感总分呈正相关（r=0.36,0.68）;检查强迫得分与躯体焦虑、应激敏感性、冒险探索、社交愿望、怨恨、言语攻击呈正相关（r=0.22～0.42）;伤害他人/自己的强迫想法得分与躯体焦虑、精神焦虑、应激敏感性、缺乏自信、冲动性、冒险探索、怨恨、兴奋性、不信任、言语攻击、身体攻击得分呈正相关（r=0.32～0.66）,与安全感总分呈负相关（r=-0.57）.结论：洗涤组强迫症患者的厌恶感高于检查组和反刍思维组;反刍思维组强迫症患者的安全感低于洗涤组和检查组,而且神经质人格特质更加突出.Objective： To compare the psychological profile of patients with obsessive-compulsive disorder （OCD） that belong to 3 subgroups named washing, checking and rumination. Methods： According to the ICD-10 Classification of Mental and Behavioral Disorders, 80 inpatients and outpatients with OCD and 80 healthy controls were recruited to investigate with the Padua Inventory-Washington State University Revised （ PI-WSUR ）, Swedish Universities Scales of Personality （SSP） , Security Questionnaire and Chinese Disgust Scale. Based on the scores of PI-WSUR all the patients were divided into 3 subgroups namely washing, checking and rumination. The data were analyzed through analysis of variance, Kruskal-Wallis H test and correlation analysis. Results： （ 1 ） There were 29 washers, 32 checkers and 19 ruminators. （2） The SSP scores of somatic trait anxiety and psychic trait anxiety in ruminators [ （70.3±11.0）, （72.8±9.7）] were higher than in washers [ （56.6±11.9）, （66.5 ±8.9）] and checkers [ （ 61.4 ± 10. 7 ）, （ 66. 2 ± 7.9 ） ], which were higher than in health controls [ （ 50. 5 ± 8.9 ）, （ 50. 8 ± 9. 7 ） ] （ Ps 〈 0. 05 ） . （ 3 ） The scores of the Security Questionnaire in ruminators （ 37. 9 ± 7. 1 ） were lower than in washers （ 47.0 ± 9. 5 ） and checkers （ 48.5 ± 8.9 ） , which were lower than in health controls （ 62. 8 ± 11.3 ） （ Ps 〈 0. 05 ） . （ 4 ） The scores of the Chinese Disgust Scale in washers were higher than in checkers, ruminators and healthy controls [ （103.0±9.5） vs. （89.7±11.0）, （85.3±10.8）, （86.2±13.5）, Ps〈0.01] . （5） The scores of contamination obsessions and washing compulsion were negatively correlated with the SSP scores of lack of assertiveness and social desirability （ r = - 0. 23, - 0. 38 ）, positively correlated with the SSP scores of detachment and the scores of Chinese Disgust Scale （ r = 0. 36, 0. 68 ± respectively. The scores of checking compulsions were positively

关 键 词：强迫症 分型 人格特征 安全感 厌恶感 横断面研究 

分 类 号：R749.79[医药卫生—神经病学与精神病学] R749.91[医药卫生—临床医学]