双相情感障碍复发相关的社会心理特征因素研究  

Psychosocial characteristics associated with relapse of bipolar disorder

作　　者：闫爱国 刘鑫子 尹冬青 朱虹 贾竑晓[2,3] 李自艳 Yan Aiguo;Liu Xinzi;Yin Dongqing;Zhu Hong;Jia Hongxiao;Li Ziyan(Beijing Pinggu Psychiatric Hospital Office,Beijing 101201,China;The National Clinical Research Center for Mental Disorders&Beijing Key Laboratory of Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China;Advanced Innovation Center for Human Brain Protection,Capital Medical University,Beijing 100069,China)

机构地区：[1]北京市平谷区精神病医院院办,北京101201 [2]首都医科大学附属北京安定医院国家精神心理疾病临床医学研究中心精神疾病诊断与治疗北京市重点实验室,北京100088 [3]首都医科大学人脑保护高精尖创新中心,北京100069

出　　处：《首都医科大学学报》2023年第4期602-608,共7页Journal of Capital Medical University

摘　　要：目的探索影响双相情感障碍(bipolar disorder,BD)复发的社会心理特征。方法选取2020年8月至2022年1月间于首都医科大学附属北京安定医院门诊就诊的BD患者共计269例,根据BD是否发作分为发作组(194例)和稳定组(75例),统计两组患者的基本信息、临床特征、药物依从性、情感气质、社会支持、儿童期创伤和五态人格之间的差异,再以逻辑回归和中介效应确定BD复发相关的危险因素及其之间的中介关系。结果循环气质、激惹气质、太阴人格与BD复发成正相关,而客观社会支持与BD复发成负相关;客观社会支持与抑郁情绪之间存在直接效应,效应值为-0.08;循环气质和太阴人格皆在客观社会支持与抑郁情绪之间有中介作用,中介值分别为-0.018和-0.028,总的间接效应为-0.046,客观社会支持与抑郁情绪之间的总效应值为-0.127,中介作用占总效应的36.2%。结论BD患者接受到的客观社会支持越多,抑郁情绪的水平越低,基于人格和气质的社会心理干预可能有助于改善社会支持不佳引起的BD复发。Objective To explore the psychosocial characteristics affecting relapse of bipolar disorder(BD).Methods A total of 269 BD patients from the outpatient department of Beijing Anding Hospital Affiliated to Capital Medical University from August 2020 to January 2022 were selected and divided into group of mood episode and group of non-mood episode.The differences of basic information,clinical characteristics,medication compliance,affective temperament,social support,childhood trauma and five-pattern personality of the two groups were analyzed.Then logical regression and mediating effect were used to determine the risk factors related to BD recurrence and the mediating relationship of these factors.Results Cyclothymic temperament,irritable temperament and Taiyin personality were positively correlated with BD relapse,while objective social support was negatively correlated with BD relapse.There was a direct effect between objective social support and depression,with an effect value-0.08.Both Cyclothymic temperament and Taiyin personality had mediating effects between objective social support and depressive mood,with the mediating values-0.018 and-0.028,respectively,and the total indirect effect was-0.046.The total effect value between objective social support and depressive mood was-0.127,and the mediating effect accounted for 36.2%of the total effect.Conclusions The more objective social support BD patients received,the lower the level of depressive mood.Social psychological intervention based on personality and temperament may help to suppress the recurrence of BD caused by poor social support.

关 键 词：双相情感障碍 社会心理特征 循环气质 五态人格 复发 

分 类 号：R749.4[医药卫生—神经病学与精神病学]