躯体形式障碍患者人格倾向与临床疗效

目的:调查躯体形式障碍患者的人格障碍倾向,比较帕罗西汀对有人格障碍倾向患者的临床疗效。方法:应用人格诊断问卷第4版(PDQ-4)对符合研究条件的58例躯体形式障碍患者筛查,筛查阳性的患者作为研究组,其余分入对照组,两组服用帕罗西汀治疗,应用症状自评量表(SCL-90)评定疗效,分别在治疗前和治疗的2、4、8周末各评定1次,比较两组间的疗效。结果:58例患者中人格障碍筛查阳性34例(58.62%),焦虑组阳性率最高(30例,51.72%),奇异古怪组(24例,41.38%)和表演组(23例,39.66%)稍低。阳性率比较高的人格亚型为强迫型(29例,50.00%)、回避型(22例,37.93%)和偏执型(21例,36.21%)。治疗结束时,研究组(34例)显效率50.00%,有效率85.29%,对照组(24例)显效率54.17%,有效率87.50%,两组间显效率和有效率无统计学差别(χ2=0.098,0.022;P0.05),治疗2周后两组SCL-90躯体化、焦虑、抑郁因子分与治疗前比较均有明显下降(P0.01),4周时的躯体化因子与4、8周时的焦虑因子两组间差别显著(P0.05)。结论:躯体形式障碍患者的人格障碍倾向明显。具有明显人格障碍倾向的患者与其他患者比较临床疗效大体相当。人格倾向相对不明显的患者在焦虑、躯体症状方面的疗效更好。

A Study of Personality Disorder Tendencies and Curative Effect in Patients with Somatoform Disorder

Objective :To study the personality disorder tendencies and curative effect in patients with somatoform disorder .Methods :58 patients with somatoform disorders were assessed by personality diagnostic questionnaire (PDQ- 4) ;Patients with positive personality disorders screening were in study group ,others were in control group ,all pa‐tients were treated with paroxetine for 8 weeks .The efficacy were evaluated with Symptom Checklist - 90(SCL - 90) before the treatment and after 2 ,4 ,8 weeks .Results :In the 58 patients ,the positive of personality disorders screening were 34 cases(58 .62% ) ,the anxious group was 30 cases(51 .72% ) ,odd or eccentric group was 24 cases(41 .38% ) , dramatic and erratic group was 23 cases(39 .66% ) ,the frequent types of personality disorders were obsessive - com‐pulsive(29 cases ,50 .00% ) ,avoidant(22 cases ,37 .93% )and paranoid(21 cases ,36 .21% ) .After treatment ,the obvious effective rate and total effective rate of study group were 50 .00% and 85 .29% ,the control group were 54 .17% and 87 .50% ,there were no difference between two groups(χ2 = 0 .098 and 0 .022 P > 0 .05) .the scores o f somatiz ation , anxiety and dep ression factor o f SCL - 90 were reduced significantly in two groups after treatment(P < 0 .01) , there were significantly difference between two groups in somatization factor at 4 week and in anxiety factor at 4 ,8 week(P < 0 .05) .Conclusion :Somatoform disorder patients have high tendency for personality disorder .There is simi‐lar efficacy with all patients .The patients of negative of personality disorders screening have better efficacy than oth ‐ers in symptom of somatization and anxiety .