抑郁发作患者的心理创伤情况调查  

Survey of psychological trauma in patients with depressive episode

作　　者：赵崇邦 周丽娜 叶莉 王相兰[1] ZHAO Chongbang;ZHOU Lina;YE Li;WANG Xianglan(Department of Psychiatry,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院精神科,广东广州510630

出　　处：《广东药科大学学报》2020年第6期870-875,共6页Journal of Guangdong Pharmaceutical University

摘　　要：目的调查精神科门诊首诊抑郁发作患者心理创伤情况及其对心理健康状态的影响。方法采用自编心理创伤事件问卷对我院精神科门诊半年内所有抑郁发作患者进行调查,统计创伤事件类型、创伤严重程度及对当前心理状态的影响程度,并分析其性别、不同年龄段的分布差异。采用EPQ和SCL-90评估其人格特征和精神症状谱,分析创伤严重程度对EPQ、SCL-90各因子分的影响。结果共纳入抑郁发作患者2205例,其中1542例(69.9%)曾经历心理创伤,学习或工作成绩不满意(51.9%),童年被忽视(37.1%),长期人际关系紧张(35.9%),被欺凌(21.4%),家庭暴力(20.9%)最为常见;36.8%经历1种创伤事件,29.1%经历2种创伤事件,34.2%经历3种创伤事件,经历事件类型越多则创伤对当前心理状态的“仍有明显影响”的比例越高(χ^2=60.919,P<0.001);25岁以下来诊者创伤严重程度高于其他年龄组(χ^2=128.785,P<0.001)。创伤程度越严重组EPQ精神质、神经质因子均分越高而内外向、掩饰性因子均分越低(P<0.001),且SCL-90各因子均分均越高(P<0.001)。结论大多数精神科门诊抑郁发作患者有心理创伤史,创伤经历可影响其个性心理特征,并增加其当前临床症状的复杂性和严重性。Objective To investigate the impact of psychological trauma on mental health status in first-visit-patients with depressive episode.Methods All patients with depressive episode were investigated by self-designed psychological trauma event questionnaire in our hospital within half a year.The types of trauma events,the severity of trauma and the impact on the current psychological state were analyzed,and the distribution differences among gender and different age groups were evaluated.Eysenck Personality Questionnaire(EPQ)and Symptom Checklist 90(SCI-90)were used to measure the personality characteristics and psychiatric symptoms,and the influence of trauma severity on each factor score of EPQ and SCL-90 was analyzed.Results A total of 2205 patients with depressive episode were included,of whom 1542(69.9%)had experienced psychological trauma,unsatisfactory academic or work performance(51.9%),neglected childhood(37.1%),long-term interpersonal tension(35.9%),being bullied(21.4%),and domestic violence(20.9%).The proportions of one,two and three traumatic events were 36.8%,29.1%and 34.2%,respectively.More traumatic events had a greater impact on current mental health status(χ^2=60.919,P<0.001).Patients aged less than 25 years had more severe trauma than patients in other age groups(χ^2=128.785,P<0.001).For the EPQ score in the more severe trauma group,higher mean score of psychoticism and neuroticism was associated with lower extroversion/introversion factor score and higher score of all factors in SCL-90(P<0.001).Conclusion Most psychiatric outpatients with depressive episode have a history of psychological trauma.Trauma experience can affect their personality and psychological characteristics,and increase the complexity and severity of their current clinical symptoms.

关 键 词：心理创伤 心理健康 抑郁症 个性心理特征 

分 类 号：R749[医药卫生—神经病学与精神病学]