Life satisfaction in patients with chest pain subsequently diagnosed as coronary heart disease – connection through depressive symptoms?

The aim of this study was to investigate factors associated with life dissatisfaction in symptomatic patients (n = 144) with chest pain subsequently diagnosed as coronary heart disease (CHD) by coronary angiography. Life dissatisfaction was assessed with a four-item life satisfaction scale (LS), depression with the 21-item Beck Depression Inventory (BDI) and other psychiatric symptoms with the symptom check list (SCL). DSM-III-R Axis I and Axis II psychiatric diagnoses were performed by means of the Structured Clinical Interview. All assessments took place one day before angiography. Twenty-four per cent of CHD patients were dissatisfied with their lives. Life dissatisfaction was associated with being unmarried. Dissatisfied patients had Axis I mental disorders and Axis II personality disorders more frequently than others. Psychiatric and depressive symptoms according to the SCL and BDI, respectively, were also higher among dissatisfied patients. In multiple logistic regression analyses, mental disorders were related to life dissatisfaction when age, sex, employment status, New York Heart Association class, duration of chest pain symptoms and work load were controlled in the model. Married subjects had a lower probability of being dissatisfied with their lives than other subjects (Odds Ratio, OR: 0.23). When BDI scores were included in the model, the only factor independently associated with life dissatisfaction was the severity of depressive symptoms (OR: 1.81). To conclude, life dissatisfaction is not primarily determined by the severity of CHD but by the existence of depressive symptoms.     

Alexithymia in Holocaust Survivors with and Without PTSD

Alexithymia was measured in non-treatment seeking, community-dwelling Holocaust survivors using the Toronto Alexithymia Scale—Twenty Item Version (TAS-20). Scores of survivors with (n = 30) and without (n = 26) posttraumatic stress disorder (PTSD) were compared, and associations among alexithymia, severity of trauma, and severity of PTSD symptoms were determined. Survivors with PTSD had significantly higher scores on the TAS-20 compared to survivors without PTSD. TAS-20 scores were significantly associated with severity of PTSD symptoms, but not with severity of trauma. This study adds to our knowledge of the relationship between alexithymia and trauma by demonstrating that this characteristic is related to the presence of posttraumatic symptoms and not simply exposure to trauma.     

Psychological factors influencing the surgical patients' consent to regional anaesthesia

To investigate the preoperative attitude of surgical patients to regional anaesthesia, 162 subjects scheduled for elective surgery were studied. On the day before operation, patients were interviewed by an anaesthesio–logist, using a semi–structured schedule. Topics investigated were sociodemographic variables and clinical correlates, such as past anaesthetic experience, information about anaesthesia and surgery, as well as questions and fears related to anaesthesia. Subjects were assessed for personality characteristics and emotional symptoms by Eysenck's Personality Questionnaire (EPQ), Zung's Self–rating Anxiety and Depression Rating Scales, Schalling–Sifneos' Personality Scale and the 43–item Life Events Inventory of Holmes and Rahe. Seventy–one patients (44%) consented to regional anaesthesia. Consent to regional anaesthesia was associated with advanced age, low neuroticism and high extroversion score in the EPQ, as well as longer duration of illness. The deniers of consent asked more questions and expressed more fears about anaesthesia. It is suggested that the patients' characteristics influence their preference, acceptance or refusal of regional anaesthesia.     

青少年强迫症病人父母的述情障碍研究

目的 探讨青少年强迫症病人父母的述情障碍和心理健康状况及其关系。方法 使用TAS、SCL—90对102例13—19岁青少年强迫症病人父母共102人和心理健康青少年的父母89人进行测评。结果 强迫症病人父母的述情障碍总分、因子Ⅰ—Ⅳ均高于对照组(P＜0．01)；SCL—90中的身体化、强迫、忧郁、焦虑、敌对、偏执、精神病性等因子分阶段和总分均显著高于对照组(P＜0．01)。59例(57．84％)有心理问题。强迫症病人父母TAS总分与SCL—90中的躯体化(P＜0．01)、强迫(P＜0．01)、焦虑(P＜0．01)和精神病性(P＜0．01)正相关；与敌对性(P＜0．01)负相关。结论 强迫症病人父母常常有述情障离、心理健康问题。给予强迫症病人父母心理帮助经常是必要的。     

养路工行为类型及述情障碍的调查研究

目的　探讨养路工行为类型及述情障碍的发生及分布。方法　采用《职业人群生命质量综合评定量表》 ,对 474例养路工 ,5 2 0例其他不同职业人群和对照组进行问卷调查。结果　养路工行为类型偏向于B-型 ,述情障碍发生概率显著高于其他职业人群 ,述情障碍的发生与B-行为类型、年龄及职业环境有关。结论　养路工人的行为类型以B-为主 ,B型行为类型者易患述情障碍。     

Alexithymia in neurodegenerative disease

We investigated alexithymia, a deficit in the ability to identify and describe one's emotions, in a sample that included patients with neurodegenerative disease and healthy controls. In addition, we investigated the relationship that alexithymia has with behavioral disturbance and with regional gray matter volumes. Alexithymia was examined with the Toronto Alexithymia Scale-20, behavioral disturbance was assessed with the Neuropsychiatric Inventory, and regional gray matter volumes were obtained from structural magnetic resonance images. Group analyses revealed higher levels of alexithymia in patients than controls. Alexithymia scores were positively correlated with behavioral disturbance (apathy and informant distress, in particular) and negatively correlated with the gray matter volume of the right pregenual anterior cingulate cortex, a region of the brain that is thought to play an important role in self and emotion processing.     

伴述情障碍的精神分裂症患者的抑制控制

目的:研究伴述情障碍的精神分裂症患者的抑制控制功能。方法:对50例符合入组标准的伴述情障碍的精神分裂症患者以及年龄、性别、受教育程度相匹配的50名精神分裂症患者实施Stroop色词测验。结果:与对照组相比,伴述情障碍的精神分裂症患者Stroop色词测验卡片C反应时长于对照组(t=3.104,P0.01)、正确阅读数低于对照组(t=-2.882,P0.01);卡片A反应时、正确阅读数差异均无统计学意义(t=1.285,-0.995;P0.05),卡片B反应时与对照组差异无统计学意义(t=1.81,P0.05),正确阅读数差异无统计学意义(t=-1.247,P0.05)。与对照组相比,伴述情障碍的精神分裂症患者干扰量高于对照组(t=2.264,P0.05)。结论:伴述情障碍的精神分裂症患者相对非述情障碍的精神分裂症患者存在更严重的抑制控制功能损害,临床工作中应给予针对性的认知干预,将有助于促进康复。     

The Impact of Alexithymia on Desire for Alcohol during a Social Stress Test

Background: Alexithymia is a personality construct comprising difficulty in identifying and describing emotions and externally oriented thinking. Its role in heavy and problematic alcohol consumption is well documented, together with its relationship with social stress. However, little research has examined whether social stress has any effect on desire for alcohol among alexithymic individuals. Objectives: In this experimental study, we explored the relationship between alexithymia and desire for alcohol in response to an experimental social stressor. Methods: One hundred and thirty eight social drinkers completed the Toronto Alexithymia Scale, self-report measures of alcohol consumption and a stress-inducing task. Desire for alcohol was measured at three time points: baseline, stressor and recovery. Results: Correlation analysis demonstrated that alexithymia was associated with significantly higher rates of alcohol consumption and higher levels of desire for alcohol. Mixed measures ANOVA demonstrated a significant main effect of alexithymia and a significant group by time effect of alexithymia on desire for alcohol. Conclusions/Importance: The findings demonstrate increased desire for alcohol before, during and after a social stressor among alexithymic participants. These findings offer an insight into the relationship between alexithymia, social stress and alcohol consumption.     

Alexithymia and anger in patients with fibromyalgia

Our objective was to delineate the relevance of the personality construct alexithymia and anger-in in patients with fibromyalgia syndrome. Fifty subjects with fibromyalgia syndrome were compared to 20 subjects with rheumatoid arthritis and 42 healthy controls on the measures of anxiety, depression, anger, alexithymia, pain intensity and disability. There was a significant difference on the measures of anxiety and anger between FMS and RA groups, and also between FMS patients and healthy controls. There was a significant difference between FMS patients and healthy controls on the measures of depression, difficulty in identifying feelings subscale of TAS (TAS-dif), and total alexithymia scores. When the severity of pain was controlled for, there was a significant difference on the measures of anger and alexithymia between the FMS and the RA groups. Fibromyalgia patients were more alexithymic than rheumatoid arthritis patients even when the level of depression was controlled for. Anger towards oneself, which is anger-in, was higher in patients with fibromyalgia patients than in the rheumatoid arthritis sample. A stepwise regression model showed that the anger-out scores and the anxiety scores predicted the level of pain severity, and this explained 32% of the variance in the fibromyalgia syndrome group. Although anger-in is consistently higher in fibromyalgia patients, it is the behavioral expression of anger, together with anxiety, that predicts the severity of the pain. The difficulty of identifying feelings, rather than other dimensions of alexithymia, seems to be associated with fibromyalgia.Abbreviations CLBP Chronic low back pain - FMS Fibromyalgia syndrome - RA Rheumatoid arthritis - VAS Visual analog scale     

潜艇军人的述情障碍特点及与应对方式关系

目的探讨潜艇军人的述情障碍特点以及述情障碍程度与所用应对方式的关系。方法采用20个条目多伦多述情障碍量表(TAS-20)、应付方式问卷(CSQ)、自编一般资料问卷对369名潜艇军人进行测评。据一般资料特征将被试分为义务兵、士官、军官组,独生子女与非独生子女组,对不同组别的TAS得分进行比较;以TAS得分区分述情障碍高、中、低分组,对3组的CSQ各分量表得分进行比较;对369名潜艇军人的CSQ得分与TAS得分进行相关分析。结果义务兵、士官与军官组的TAS总分、F1、F3因子分间差异具有统计学意义(F=8.18,11.19,3.42;P<0.05);独生子女组F3因子分高于非独生子女组差异具统计学意义(t=2.67,P<0.01);述情障碍高、低、中分组的CSQ6个分量表得分差异均具统计学意义(F=12.48,37.58,20.24,23.88,32.40,23.19;P<0.01),两两比较中,高分组在不成熟型或混合型应对方式自责、幻想、避让和合理化因子得分上高于中、低分组(P<0.01);在成熟型应对方式解决问题、求助分量表得分上低于中、低分组(P<0.01)。相关分析显示,应付方式分量表中解决问题、求助分量表得分与TAS总分及各因子分间负相关有统计学意义(r=-0.192～-0.350,P<0.01),自责、幻想、退避、合理化各分量表得分与TAS总分及各因子分间正相关有统计学意义(r=0.169～0.505,P<0.01)。结论义务兵、士官、军官的述情障碍程度不同,主要体现在情感辨认与外向性思维上;潜艇军人的应对方式与述情障碍程度有关,高述情障碍者倾向于采用不成熟应对方式。