强迫症的临床特征与MMPI的变化-4年的随访研究  

Clinical features and polyphasic personality of obsessive-compulsive disorder :a 4-year follow-up study

作　　者：郭慧荣[1] 任玉明 黄百灵 冯焱燚 李冬云 GUO Huirong;REN Yuming;HUANG Bailing(Department of Psychiatry,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院精神医学科,郑州450052 [2]新乡医学院教务处和心理学院 [3]郑州煤炭工业集团有限责任公司总医院心理科

出　　处：《国际精神病学杂志》2020年第6期1153-1156,共4页Journal Of International Psychiatry

基　　金：河南省2017年科技发展项目(编号:172102310578):强迫性障碍患者蛋白质弥散张量成像研究。

摘　　要：目的随访强迫症4年的临床特征、疗效转归及明尼苏达多相人格(MMPI)的变化,分析疗效与MMPI的关系。方法153例强迫症患者完成以下数据收集并进行四年的回访:(1)采用自制的一般情况调查表收集强迫症的临床特征、治疗过程、疗效转归、病程特点等。(2)采用自身前后对照的方法,分析强迫症患者临床症状(YBOCS、HAMA、HAMD)的变化;分析前后两次MMPI的变化,以及预后与MMPI变化的关系。结果随访时HAMA评分(8.7±4.8),HAMD评分(12.0±6.6),Y-BOCS评分(16.4±8.4),较入组时均明显降低(P<0.01),两次MMPI编码模式呈2-7-4或7-2-4。前后比较,K、Hy、Hs、Pa因子分明显降低。预后较差组MMPI中的"Hs"、"D"、"Hy"、"Pa"、"Mas"、"Pd"、"Pt"、"Sc"、"Si"等多项评分均高于其它两组(P<0.05)。结论病态人格的变化与疗效有关,说明心理特征的异常在强迫症的发病中有重要作用。根据MMPI聚类分析,可根据人格特点对强迫症患者进行分类,为强迫症的治疗选择提供依据。Objective The clinical features,prognosis and changes of multiphase personality of OCD patients were followed up for 4 years. The relationship between therapeutic effects and the MMPI were analyzed. Method A total of 153 patients with obsessive-compulsive disorder who completed the baseline assessment of the required data,including(1)A self-made questionnaire was used to collect the clinical characteristics,treatment process,prognosis and course of disease of OCD.(2)The changes of clinical symptoms(YBOCS,HAMA,HAMD,)of patients with OCD were analyzed by self before and after control;The changes of MMPI were analyzed before and after treatment. Results During follow-up the HAMA score(8.7±4.8),the HAMD score(12.0±6.6),and the Y-BOCS score(16.4±8.4)were significantly lower than those at the time of enrollment(P<0.01). The coding mode of the two MMPI assessment profiles is 2-7-4 or 7-2-4. compared with baseline,The K,Hy,Hs,and Pa factor scores of the patients were significantly decreased,and the Re factor scores were increased(P<0.05). The Hs,D,Hy,Pa,Mas,Pd,Pt,Sc and Si scores in patients with bad effects were higher than the others patients. Conclusion The change of morbid personality disorder(MMPI)is significantly correlated with prognosis,which means that the abnormality of psychological characteristics plays an important role in the pathogenesis of OCD. According to MMPI clustering analysis,a new classification method for OCD was proposed,which may provide a basis for treatment selection of OCD.

关 键 词：强迫症 随访 病程转归 预后 MMPI 

分 类 号：R749.7[医药卫生—神经病学与精神病学]