发作期抑郁症患者述情障碍影响因素的多元分析

目的探讨发作期抑郁症患者述情障碍的相关因素。方法采用多伦多述情量表（TAS）中文版、Beck抑郁自评量表（BDI）对80例发作期抑郁症患者进行评定,并与95名健康志愿者（对照组）比较。结果（1）抑郁症组TAS因子Ⅰ、Ⅱ、Ⅲ、总分及BDI评分均显著高于对照组（P〈0．01）。（2）患者住院与他人交流、抑郁总分依次进入TAS因子Ⅰ的回归方程;抑郁总分、工作学习应激、性别依次进入TAS因子Ⅱ的回归方程;受教育年限、住院与他人交流依次进入TAS因子Ⅲ的回归方程;抑郁总分、治疗信心依次进入TAS总分的回归方程。结论抑郁发作患者存在明显的述情障碍。性别、受教育年限、抑郁的严重程度等为发作期抑郁症患者述情障碍的重要影响因素。述情障碍不同因子的影响因素不尽相同。     

神经症和抑郁障碍患者的述情障碍及相关因素研究

目的探讨神经症和抑郁障碍患者的述情障碍及影响因素。方法对57例神经症和抑郁障碍患者运用多伦多述情障碍量表(TAS)进行评定，并与常模进行比较。结果神经症和抑郁障碍患者存在明显的述情障碍，TAS总分及各因子分明显高于常模，男女之间无显著性差异，多元回归分析进入方程的是SCL-90躯体化因子和焦虑因子。结论正确评定神经症和郁郁障碍患者的述情障碍及影响因素，具有重要的临床现实意义，对采用适当的心理治疗提供依据。     

长期住院精神分裂症患者述情障碍的研究

目的　探讨长期住院的精神分裂症患者的述情障碍问题。方法　对100例长期住院的精神分裂症患者采用多伦多述情障碍量表(TAS量表)评定,并根据年龄、文化程度、病程、住院时间、药物剂量的不同对患者进行分组对比。结果　长期住院的精神分裂症患者 TAS 均分及各因子分高于常模,且不同年龄、病程、住院时间的患者总均分及部分因子分存在明显的差异。结论　长期住院的精神分裂症患者存在一定的述情障碍。     

心身疾病与神经症患者的述情障碍研究

目的 探讨心身疾病与神经症患者的述情障碍情况。方法 以多伦多述情障碍量表(TAS)对51例心身疾病,31例神经症患者进行测评,并与正常人作对照。结果心身疾病,神经症患者TAS总分分别为76.13±7.88,73.22±9.88。明显高于正常对照组66.06±6.38。因子分中以Ⅰ、Ⅱ、Ⅳ因子为显著。提示述情障碍常见于心身疾病及神经症患者,临床医师应予以重视。     

消化性溃疡患者的情绪障碍和述情障碍

用汉密顿焦虑量表（HAMA）、汉密顿抑郁量表（HAMD）和多伦多述情障碍量表（TAS）对57例住院的消化性溃疡患进行评定，并与57例正常健康自愿为对照，结果发现消化性溃疡患HAMA、HAMD总分和TAS总分及四个因子分均显高于对照组，说明消化性溃疡患中存在情绪障碍和述情障碍。     

海洛因依赖者述情障碍研究

目的:了解海洛因依赖者(PHD)述情障碍特征及与负性情绪的关系. 方法:对194例男性PHD(PHD组),采用自编一般情况问卷、多伦多述情障碍量表(TAS)、抑郁自评量表(SDS)及焦虑自评量表(SAS)进行心理评估;107名健康男性作为对照,采用TAS进行述情障碍测评. 结果:PHD组TAS总分及各因子分、SDS及SAS评分均显著高于对照组(P<0.05或P<0.01);TAS总分及因子Ⅰ、因子Ⅱ、因子Ⅳ与SDS、SAS总分均呈显著正相关(r=0.178～0.294,P均<0.05或P<0.01);TAS因子Ⅲ与SAS总分均呈显著负相关(r=-0.147,P<0.05). 结论:男性PHD存在明显述情障碍,并与负性情绪密切相关.     

恢复期精神分裂症病人述情障碍的对比分析

目的　评估恢复期精神分裂症病人的述情障碍 ,并比较其缺陷型和非缺陷型的述情障碍严重程度。方法　采用多伦多述情障碍量表 (Torontoalexithymiascale ,TAS)对 6 6例恢复期精神分裂症病人及 6 2例正常人进行测查。结果　恢复期精神分裂症病人的TAS得分显著高于正常人 (P <0 0 5或P <0 0 1) ,其缺陷型的TAS得分也显著高于非缺陷型 (P均 <0 0 1)。结论　恢复期精神分裂症病人大多存在述情障碍 ,其中缺陷型病人的述情障碍更为严重。严重的述情障碍可能是精神分裂症病情加重或存在原发阴性症状的一个标志。     

原发性高血压患者的述情障碍研究

目的探讨原发性高血压患者的述情障碍情况.方法以多伦多述情障碍量表(TAS)对69例原发性高血压患者进行测评并与正常人作对照.结果高血压患者TAS总分为(74.06±8.77)分,明显高于对照组(66.06±6.38)分,因子分中以Ⅰ、Ⅱ、Ⅳ因子为显著,男,女患者之间无差异.结论述情障碍常见于原发性高血压患者,临床医师应预以重视.     

躯体形式障碍患者的述情障碍

目的：探讨躯体形式障碍患者的心理健康状况,以及与述情障碍的关系.方法：采用症状自评量表（SCL-90）及多伦多述情障碍量表（TAS）对60例躯体形式障碍患者（患者组）和60名健康自愿者（对照组）进行测评,并对躯体形式障碍患者的心理健康状况与述情障碍作相关分析.结果：患者组SCL-90总分及躯体化、人际关系敏感、抑郁、焦虑、偏执、精神病性6个因子评分均显著高于对照组（P＜0.05或P＜0.01）;其TAS总分及因子Ⅰ、Ⅱ、Ⅳ评分亦均显著高于对照组（P＜0.05或P＜0.01）,而因子Ⅲ评分两组间比较,差别则无统计学意义.躯体形式障碍患者的SCL-90总分与TAS总分及因子Ⅰ、Ⅱ、Ⅳ评分均呈显著性正相关;而与因子Ⅲ评分则无显著性相关.结论：躯体形式障碍患者的心理健康状况较差,并与述情障碍有关.     

抑郁症患者的述情障碍特征及情绪调节研究（英文）

背景:抑郁症患者表现出明显的述情障碍,而关于其述情障碍的机制尚未明确,也较少有关于抑郁症患者情绪调节能力的研究。目的:探索抑郁症患者的述情障碍特征,以及抑郁症状、述情障碍与个体情绪调节能力的关系。方法:采用汉密尔顿抑郁量表(HAMD-24)、汉密尔顿焦虑量表(HAMA)、多伦多述情障碍量表(TAS)和计算机情绪调节实验,对36名抑郁症患者和31名健康志愿者进行评定分析。结果:病例组中述情障碍发生率为66.67%,对照组为3.23%,两组比例差异有显著性(χ~2=28.661,p0.001)。病例组的TAS得分显著高于对照组(t=7.378,p0.001)。情绪调节实验中,病例组观看中性图片的评分显著高于对照组(t=2.080,p=0.043);而负性-观看、负性-重评和负性-抑制三种实验条件下,两组评分无显著差异。在病例组中,HAMD-24、HAMA与TAS得分之间存在显著相关,而情绪调节实验得分与HAMD-24、HAMA、TAS之间均未发现相关。结论:抑郁症患者中述情障碍的发生率可能高于一般人群,其抑郁症状与述情障碍之间可能存在相互影响。情绪调节能力可能是一种独立的特质,与抑郁状态无关。     

Correlations between alexithymia and pain severity,depression, and anxiety among patients with chronic and episodic migraine

Aims: Some studies have found elevated alexithymia among patients with chronic pain, but the correlations between alexithymia and the severity of pain, depression, and anxiety among migraine patients are unclear. The aims of the present study were to investigate whether individuals suffering from episodic migraine (EM) differ from those with chronic migraine (CM) in regards to depression, anxiety, and alexithymia measures and to investigate the association of alexithymia with the results of depression and anxiety test inventories and illness characteristics. Methods: A total of 165 subjects with EM and 135 subjects with CM were studied. The Beck Depression Inventory (BDI), State–Trait Anxiety Inventory (STAI), and Toronto Alexithymia Scale (TAS) were administered to all subjects. The correlation between alexithymia and sociodemographic variables, family history of migraine and illness characteristics (pain severity, frequency of episode, duration of illness) were evaluated. Results: Compared with EM patients, the CM patients had significantly higher scores on measures of depression but not alexithymia and anxiety. There was a positive correlation between TAS scores and age and education in both migraine groups, but there was no correlation between TAS scores and other demographic variables. Depression and anxiety were significantly correlated with alexithymia in both migraine groups. Conclusion: Our results indicate that CM patients are considerably more depressive than EM patients. In this study, depression and anxiety were significantly correlated with alexithymia in both migraine groups. Our results demonstrate a positive association between depression, anxiety, and alexithymia in migraine patients.     

Distribution of alexithymia as a personality-trait in psychosomatically ill in-patients--measured with TAS 20 and LEAS

Preliminary findings of an ongoing study of the distribution of alexithymia in different diagnostic-groups of psychosomatically ill in-patients (n = 240, will be increased to n = 400) are reported. Alexithymiea is measured simultaneousely by the Levels of Emotional Awareness Scale (LEAS, a performance-test) and the 20-item Toronto Alexithymia Scale (TAS 20, a self-report-scale). Measured by the LEAS and compared with other diagnostic groups (affective, anxiety and compulsive-obsessive disorders; adjustment disorders; eating disorders), patients with somatoform disorders showed a decreased ability to be aware of and to communicate their emotional states. This finding which meets theoretical considerations about the origin of alexithymia could not be found with the TAS 20. The TAS 20 did not differentiate between the diagnostic groups, but showed - in accordance with two other self-report-scales (STAI for self reported anxiety as a personality trait and SCL-90-R for self reported somatic und psychic complaints) - higher mean scores at the onset than at the end of treatment. Methodical implications of the different findings of the two alexithymia scales are discussed.     

Multidimensionality and state dependency of alexithymia in recently sober alcoholics

In this study, we a) examined the appropriateness of using a single global score to represent alexithymia and b) constructed a model to examine the relationship between alexithymia and depression in recently sober alcoholics applying for inpatient care. To measure alexithymia, we used the Toronto Alexithymia Scale (TAS); to measure depression, we used the revised Beck Depression Inventory (BDI). Factor analyses identified three alexithymia factors (Feelings, Daydreaming, and External Thinking) and two depression factors (Somatic-Performance and Cognitive-Affective). The three TAS factors were not positively related to each other; the two BDI factors were. We used LISREL software to examine the relationships between the TAS factors and the BDI factors. The only two significant unidirectional coefficients were between the TAS-Feelings factor and the two BDI factors. Our results suggest that in recently sober alcoholics, alexithymia, as measured by the TAS, consists of three independent, unrelated dimensions. Moreover, only the dimension associated with an inability to identify feelings and to distinguish them from bodily sensations is related to depressive symptoms. To determine whether this alexithymia feelings dimension actually is dependent on situational depression and/or anxiety will require confirmation in additional samples, such as primary alexithymics and patients with major depressive disorders.     

酒依赖患者的情绪障碍和述情障碍

目的：探讨酒依赖患者的情绪障碍和述情障碍。方法：采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、多伦多述情障碍量表（TAS）以50例酒依赖患者和50例正常对照组进行比较研究。结果：酒依赖组与对照组在焦虑、抑郁情绪和述情障碍方面存在明显差异。结论：纠正情绪和述情障碍可能有利于戒酒成功。     

Alexithymia in Parkinson's disease is related to severity of depressive symptoms

The authors investigated the possible relationship between depression and alexithymia in a population of hospitalized patients suffering from Parkinson's disease (PD). Fifty-eight PD patients without dementia participated in the study. Alexithymia was screened using the 20 item version of the Toronto Alexithymia Scale (TAS 20). Depression was diagnosed using a Structured Clinical Interview (SCID I) for DSM-IV. Severity of depression was evaluated with the Beck Depression Inventory (BDI). The prevalence of Alexithymia was about 21%. PD patients with major depression were significantly more alexithymic (TAS 20 average score = 61.4) than PD patients without depression (TAS 20 average score = 47.4) and, also, tended to be more alexithymic than PD patients with minor depression (MiD; TAS 20 average score =50.6), whereas no difference was found between PD patients with MiD and PD patients without depression. Moreover, high scores obtained on the BDI were found to strongly predict high level of alexithymia in these patients. These results extend to a cohort of PD patients previous data from the literature evidencing a strong association between alexithymia and severity of depressive symptoms.     

Validation of the alexithymia construct: a measurement-based approach

Alexithymia is a hypothetical personality construct that has been associated with a variety of medical and psychiatric disorders. This article reviews a program of research evaluating the validity of the construct using a measurement-based, construct validation approach. For this purpose the Toronto Alexithymia Scale (TAS) was developed. In a series of studies the TAS demonstrated internal consistency, good test-retest reliability, and a stable factor structure theoretically congruent with the alexithymia construct. In separate tests of construct validity, the TAS correlated in a theoretically meaningful fashion with measures of other constructs. Criterion validity was supported by a study in which the TAS was able to discriminate between behavioural medicine outpatients designated as alexithymic and those designated as nonalexithymic on the basis of objectively rated structured interviews. In a normal adult sample, TAS scores were not related to sociodemographic variables or intelligence. These results provide considerable empirical support for the validity of the alexithymia construct. In addition, the TAS appears to be a psychometrically sound measure of alexithymia that may prove useful in testing the construct with psychiatric and medical patient populations.     

Toronto Alexithymia Scale in outpatients with sexual disorders

The Toronto Alexithymia Scale (TAS-26) was administered to patients with sexual disorders (n = 112) and to healthy control subjects (n = 94). The clinic sample was divided into three subgroups according to DSM-III-R criteria: patients with hypoactive sexual desire disorder (n = 41), patients with orgasm disorders (n = 51) and patients with male erectile disorder (n = 20). TAS scores were significantly higher for male and female patients with hypoactive sexual desire disorder, and with male erectile disorder than controls. The TAS scores in the orgasm disorder patients were not significantly different from those of controls. These results are interesting because they show an association betweeen alexithymia and some sexual symptoms.     

White matter lesions on magnetic resonance imaging in late-life depression

Objectives: The aims of the present study were to identify the frequency and severity of white matter lesions on the magnetic resonance imaging (MRI) of major depressive disorders and depression caused by cerebrovascular diseases (CVD), to evaluate the relation with cerebrovascular risk factors, and finally to understand an important cause of late‐life depression. Methods: The MRI films of 32 patients over 50 years of age (15 men and 17 women) with major depressive disorders, 25 patients (17 men and eight women) with depression caused by CVD who had scores over 24 on the mini‐mental state examination, and 25 controls (six men and 19 women) were analyzed for white matter lesions according to the modified Fazekas criteria. The cerebrovascular risk factors including hypertension, arteriosclerosis, obesity, smoking, diabetes mellitus, thyroid function abnormalities, EKG abnormality and stroke were also assessed. Results: (i) The frequency of periventricular lesions or deep white matter lesions were significantly higher in patients with depression caused by CVD and major depressive disorders than in controls; (ii) the intracerebral hyperintensities or classical infarctions were prevalent in the frontal cortex (32.0%) and basal ganglia (40.0%); (iii) among cerebrovascular risk factors, stroke (P < 0.005), hypertension (P < 0.025), EKG abnormality (P < 0.005) and smoking (P < 0.05) were significantly prevalent in the patients with depression caused by CVD and major depressive disorders as compared with controls; and (iv) the severity of white matter lesions was significantly associated with the cerebrovascular risk factors (P < 0.005) in patients over 50 years of age with major depressive disorders. Conclusions: The white matter hyperintensities on brain MRI of patients with major depressive disorders over 50 years of age were significantly associated with cerebrovascular risk factors, which suggested a vascular origin of pathogenesis of late‐life depression.     

The relationship between alexithymia and salivary cortisol levels in somatoform disorders

The purpose of this study was to investigate cortisol levels as a function of the hypothalamic-pituitary-adrenal axis (HPA) in relation to alexithymia in patients with somatoform disorders (SFD). Diurnal salivary cortisol was sampled in 32 patients with SFD who also underwent a psychiatric examination and filled in questionnaires (Toronto Alexithymia Scale, TAS scale; Screening for Somatoform Symptoms, SOMS scale; Hamilton Depression Scale, HAMD). The mean TAS total score in the sample was 55.6+/-9.6, 32% of patients being classified as alexithymic on the basis of their TAS scores. Depression scores were moderate (HAMD=13.2, Beck Depression Inventory, BDI=16.5). The patients' alexithymia scores (TAS scale "Difficulty identifying feelings") correlated significantly positively with their somatization scale scores (Symptom Checklist-90 Revised, SCL-90-R); r=0.3438 (P<0.05) and their scores on the Global Severity Index (GSI) on the SCL-90-R; r=0.781 (P<0.01). Regression analysis was performed with cortisol variables as the dependent variables. Cortisol levels [measured by the area under the curve-ground (AUC-G), area under the curve-increase (AUC-I) and morning cortisol (MCS)] were best predicted in a multiple linear regression model by lower depressive scores (HAMD) and more psychopathological symptoms (SCL-90-R). No significant correlations were found between the patients' alexithymia scores (TAS) and cortisol levels. The healthy control group (n=25) demonstrated significantly higher cortisol levels than did the patients with SFD; in both tests P<0.001 for AUC-G and AUC-I. However, the two groups did not differ in terms of their mean morning cortisol levels (P>0.05). The results suggest that pre-existing hypocortisolism might possibly be associated with SFD.