抑郁症的躯体不适与神经质、注意偏向和被束缚的关联研究

目的 探讨抑郁症病人躯体不适症状与神经质、注意偏向和被束缚程度之间的相关性，探究抑郁症躯体不适症状发病的心理机制。 方法 选择门诊确诊85例抑郁症病人(抑郁组)和93名健康志愿者(对照组)进行汉密尔顿抑郁量表(HAMD-24)、躯体症状自评量表(SSS)、艾森克人格测试量表(EPQ)、正性负性信息注意量表(APNI)、中文版神经症被束缚自评量表(SSTN)评估，分析其相关关系。 结果 抑郁组躯体症状、被束缚状态、负性注意偏向、抑郁症状评分均明显大于对照组(P < 0.01)；对照组的正性注意偏向评分明显高于抑郁组(P < 0.01)；抑郁组神经质评分明显高于对照组(P < 0.01)；抑郁组神经质和精神质评分均明显高于对照组(P < 0.01)。2组掩饰程度和内外向评分差异均无统计学意义(P>0.05)；抑郁组的抑郁程度评分与躯体不适评分呈明显正相关关系(r=0.581，P < 0.01)；而抑郁程度评分、躯体不适评分与正性注意偏向评分呈负相关关系(r=-0.355、-0.256，P < 0.01和P < 0.05)；与负性注意偏向评分呈正相关关系(r=0.234、0.393，P < 0.05)；与被束缚状态评分呈明显正相关关系(r=0.459、0.351，P < 0.01)；与神经质评分呈明显正相关关系(r=0.323、0.327，P < 0.01)；病人的被束缚评分与负性注意偏向评分呈明显正相关关系(r=0.475，P < 0.01)；神经质评分与负性注意偏向评分、被束缚状态评分呈明显正相关关系(r=0.484、0.407，P < 0.01)。 结论 抑郁症病人伴有的躯体不适、抑郁症状与其显著的负性注意偏向增强和正性注意偏向减弱、神经质人格、被束缚状态有关，神经质人格与负性注意偏向、被束缚、躯体不适、抑郁症状之间的交互作用、互相加强，可能是抑郁症躯体不适、抑郁症状发生、发展的重要心理机制之一。

Relationship between somatic discomfort and neuroticism,attentional bias and TORAWARE in depression

Objective o explore the correlation between somatic discomfort and neuroticism, attentional bias and TORAWARE in patients with depression, and to explore the psychological mechanism of somatic discomfort of depression. TMethods A total of 85 patients with depression(depression group) diagnosed in the outpatient department and 93 healthy volunteers(control group) evaluated with Hamilton depression scale(HAMD-24), self-rating scale of somatic symptoms(SSS), Eysenck personality test(EPQ), attention to positive and negative inventory(APNI) and the Chinese version of self-rating scale for the TORAWARE state of neurosis(SSTN).Their relationship was analyzed. Results The scores of somatic symptoms, TORAWARE, negative attentional bias and depressive symptoms in depression group were significantly higher than those in control group(P < 0.01).The scores of positive attentional bias of control group were significantly higher than those in depression group(P < 0.01).The scores of neuroticism and psychoticism in depression group were higher than those in control group(P < 0.01).There were no significant differences in the scores of concealment and introversion and extroversion(P>0.05).There was a positive correlation between depression degree score and somatic discomfort score in depression group(r=0.581, P < 0.01).The scores of depression and somatic discomfort were negatively correlated with the scores of positive attentional biases(r=-0.355, P < 0.01 and P < 0.05).They were significanly positively correlated with negative attentional bias(r=0.234, P < 0.05), TORAWARE score(r=0.459, 0.351, P < 0.01) and neuroticism score(r=0.323, 0.327, P < 0.01).There was a significant positive correlation between TORAWARE score and negative attentional bias score(r=0.475, P < 0.01).Neuroticism score was significantly positively correlated with negative attentional bias score and TORAWARE state score(r=0.484, 0.407, P < 0.01). Conclusions The somatic discomfort and depressive symptoms of patients with depression are related to the increase of negative attentional bias and the decrease of positive attentional bias, neuroticism personality and TORAWARE state.The interaction and mutual reinforcement between neuroticism personality and negative attentional bias, TORAWARE, somatic discomfort and depressive symptoms may be the important psychological mechanisms for the occurrence and development of somatic discomfort and depressive symptoms of depression.