成年女性神经性厌食患者的焦虑和冲动特征及其与临床症状的关系  

Anxiety and impulsivity in adult female patients with anorexia nervosa and the relationships with clinical symptoms

作　　者：杨晶菁 陈楚翘 陈超[1] 朱琳琳 孔庆梅[1] 司天梅[1] Yang Jingjing;Chen Chuqiao;Chen Chao;Zhu Linlin;Kong Qingmei;Si Tianmei(Peking University Sixth Hospital,Peking University Institute of Mental Health,NHC Key Laboratory of Mental Health(Peking University),National Clinical Research Center for Mental Disorders(Peking University Sixth Hospital),Beijing 100191,China)

机构地区：[1]北京大学第六医院、北京大学精神卫生研究所、国家卫生健康委员会精神卫生学重点实验室(北京大学)国家精神心理疾病临床医学研究中心(北京大学第六医院),北京100191

出　　处：《中华精神科杂志》2024年第12期836-843,共8页Chinese Journal of Psychiatry

基　　金：国家精神心理疾病临床医学研究中心(北京大学第六医院)自主探索课题(NCRC2020M04)。

摘　　要：目的探讨成年女性神经性厌食(anorexia nervosa, AN)患者的焦虑和冲动特征, 及其与进食障碍核心临床症状之间的关系。方法纳入2014 年6 月至2022 年10 月在北京大学第六医院门诊或住院的AN患者96例, 同期通过社区招募对照者51名, 使用状态-特质焦虑量表(State-Trait Anxiety Inventory, STAI)和Barratt 冲动性量表(Barratt Impulsiveness Scale, BIS-11)评估2组的焦虑及冲动特征, 使用进食障碍调查量表-1(Eating Disorder Inventory-1, EDI-1)评估患者的临床特征和其他心理特征;采用相关分析、回归分析等方法探索焦虑、冲动与进食障碍核心临床症状之间的关系。结果 (1)AN组EDI-1总分[(233.7±48.4)分比(184.2±30.4)分, t=7.58, P<0.001]及7个分量表(对瘦的追求:t=5.25, P<0.001;贪食:t=6.05, P<0.001;无效感:t=7.91, P<0.001;完美主义:t=3.05, P=0.003;对他人不信任:t=5.50, P<0.001;内省:t=7.00, P<0.001;成熟恐惧:t=2.46, P=0.015)的评分高于对照组。(2)AN组的状态焦虑(t=8.60, P<0.001)、特质焦虑(t=7.40, P<0.001)以及冲动总分(t=3.55, P<0.001)、注意冲动(t=2.43, P=0.017)、运动冲动(t=4.29, P<0.001)水平均高于对照组。(3)相关分析显示, 状态焦虑、特质焦虑、注意冲动、运动冲动、无计划冲动与对瘦的追求呈正相关(r=0.522、0.577、0.272、0.387、0.209, 均P<0.05);状态焦虑、特质焦虑、注意冲动、运动冲动、无计划冲动与贪食呈正相关(r=0.402、0.471、0.304、0.514、0.466, 均P<0.01);注意冲动、状态焦虑、特质焦虑与对身体不满意呈正相关(r=0.333、0.448、0.409, 均P<0.01)。进一步的岭回归结果显示, AN患者的特质焦虑是对瘦的追求的影响因素(t=3.13, P=0.002), 状态焦虑是对身材不满意的影响因素(t=1.99, P=0.050), 运动冲动、无计划冲动是贪食的影响因素(t=2.92、2.79, 均P<0.01)。结论 AN患者有更高的焦虑和冲动水平, 并且不同维度的焦虑、冲动水平与AN患者的核心临床症状相关。Objective:To explore anxiety and impulsivity in adult female patients with anorexia nervosa(AN),and the relationship with different dimensions of the core clinical symptoms.Methods:From June 2014 to October 2022,96 patients with AN,from both outpatient clinics and inpatient wards,were enrolled from Peking University Sixth Hospital.Additionally,51 control participants were recruited from the community.State-trait Anxiety Inventory(STAI)and Barratt Impulsiveness Scale(BIS-11)were used to evaluate the anxiety and impulsivity of each group.The Eating Disorder Inventory-1(EDI-1)was used to assess clinical and other psychological characteristics of ED.Correlation and regression analysis were employed to explore the relationship between anxiety,impulsivity,and core clinical symptoms of eating disorders.Results:(1)The total EDI-1 score for the AN group((233.7±48.4)vs.(184.2±30.4),t=7.58,P<0.001)and scores in 7 subscales(Drive for Thinness:t=5.25,P<0.001;Bulimia:t=6.05,P<0.001;Ineffectiveness:t=7.91,P<0.001;Perfectionism:t=3.05,P=0.003;Interpersonal Distrust:t=5.50,P<0.001;Interoceptive Awareness:t=7.00,P<0.001;Maturity Fears:t=2.46,P=0.015)were significantly higher than the control group.(2)The AN group had significantly higher levels of state anxiety(t=8.60,P<0.001),trait anxiety(t=7.40,P<0.001),total impulsivity(t=3.55,P<0.001),attentional impulsiveness(t=2.43,P=0.017)and motor impulsiveness(t=4.29,P<0.001)compared to the control group.(3)Correlation analysis showed that state anxiety,trait anxiety,attentional impulsiveness,motor impulsiveness,and non-planning impulsiveness were positively correlated with the drive for thinness(r=0.522,0.577,0.272,0.387,0.209,all P<0.05);State anxiety,trait anxiety,attentional impulsiveness,motor impulsiveness,and non-planning impulsiveness were also positively correlated with bulimia(r=0.402,0.471,0.304,0.514,0.466,all P<0.01);Attentional impulsiveness,state anxiety,and trait anxiety were positively correlated with body dissatisfaction(r=0.333,0.448,0.409,all P<0.01).Further ridge r

关 键 词：厌食 神经性 焦虑 冲动行为 回归分析 

分 类 号：R749.7[医药卫生—神经病学与精神病学]