神经症危险因素的病例对照研究

目的:广泛筛选与神经症发生有关联的人格障碍、生活事件、父母养育方式等可疑危险因素并分析其关联程度。方法:通过成组病例对照研究,用生活事件量表、父母养育方式问卷,人格诊断问卷对100名就诊于北京两家三甲精神病专科医院的神经症患者(病例组)和按照性别、年龄(±3岁)成组匹配的无精神障碍的200名上述医院的工作人员(对照组)进行自评问卷调查。结果:(1)单因素分析显示,病例组的负性生活事件得分、父亲拒绝因子得分、父亲过度保护因子得分、母亲拒绝因子得分、总体人格障碍得分均高于对照组[22.5vs.2.5,(40.4±14.1)vs.(35.4±7.9),(29.1±7.5)vs.(28.2±5.6),(40.4±13.7)vs.(36.8±8.5),(29.8±14.1)vs.(17.1±13.0);均P0.05]。(2)非条件Logistic回归分析显示,神经症发生的保护因素是正性事件(OR=0.92,95%CI:0.87～0.98);危险因素是负性事件(OR=1.06,95%CI:1.04～1.08)及总体人格障碍(OR=4.84,95%CI:2.24～10.49)。结论:正性生活事件是神经症发生的保护因素,负性生活事件和人格障碍是神经症发生的危险因素。

A case-control study of the risk factors for neurosis

Objective: To screen out suspected risk factors associated with neurosis, such as personality dis-order, life events, parental rearing behavior, and to explore degree of their associations. Methods: A case-control study was carried out among 100 cases with neurosis and 200 controls without mental disorder, matched by gender and age (+3 years) . The Life Events Scale (LES), Parental Rearing Style Questionnaire (EMBU), Personali-ty Diagnostic Questionnaire (PDQ-4) were self-reported by the subjects. Results: Single factor analysis showed that there were statistical differences (P <0.05) between case and control groups in negative life event (22.5 vs. 2.5), paternal rejection [(40.4±14.1) vs.(35.4±7.9)], paternal overprotection [(29.1±7.5)vs.(28.2±5.6)], maternal rejection rearing behavior [(40.4±13.7)vs.(36.8±8.5)], and overall personality disorder [(29.8±14.1)vs.(17.1±13.0)] . Using non-conditional logistic regression analysis, the potential protective factor was positive events (OR=0.92, 95% CI:0.87-0.98), and the potential risk factors included negative live events (OR=1.06, 95% CI:1.04～1.08) and overall personality disorder (OR=4.84, 95% CI: 2.24～10.49) . Conclusion: Positive life event may be a protective factor for neurosis, while negative life e-vent and personality disorder may be risk factors.