神经性厌食患者心理防御机制与进食态度的关系

目的：探讨神经性厌食患者（AN）的心理防御机制特征及其与临床进食态度间的关系。方法选取符合精神障碍诊断与统计手册第四版（DSM-IV）诊断标准的AN患者92例（限制型46例，暴食／清除型46例；早发16岁及以前48例，晚发16岁后44例），选取性别、年龄、婚姻、受教育程度相匹配的健康对照（HC）92例，采用防御机制问卷（DSQ）来评估防御机制特点，用进食态度问卷（EAT-26）来评估被试的进食态度，比较AN组和HC组间的防御机制和进食态度差异，比较AN不同亚组（按临床亚型和发病早晚分组）心理防御机制和进食态度的差异，分析AN患者心理防御机制与进食态度、BMI及病程之间相关关系。结果 AN组在DSQ的不成熟型防御机制、中间型防御机制得分高于HC组（4．49±1．13）分vs （3．55±0．93）分、（4．33±0．76）分 vs（3．88±0．69）分，均P＜0．01]； EAT-26总分及其三个分量表（节食、暴食和食物关注、口欲控制）得分均高于HC组（均P＜0．01）。与限制型患者相比，暴食／清除型患者组不成熟型防御机制得分较高（4．49±1．06）分 vs （4．79±1．13）分，P＝0．010]； EAT-26总分及对暴食和食物关注分量表得分较高（P＜0．001）。 DSQ中的不成熟型防御机制（r＝0．472， P＜0．001）、中间型防御机制（r＝0．315，P＝0．002）与EAT-26总分呈现正相关；不成熟防御机制（r＝0．343， P＜0．001）、中间型防御机制（r＝0．257， P＝0．014）与节食分量表得分呈现正相关；不成熟防御机制（r＝0．523， P＜0．001）、中间型防御机制（r＝0．267， P＝0．010）与暴食和食物关注得分呈现正相关；DSQ中的不成熟防御机制（ r＝0．375， P＜0．001）与病程成显著正相关；DSQ各因子分与BMI之间的相关系不显著（r＝－0．15～0．25，均P＞0．05）。结论神经性厌食患者防御机制偏?

Relationship between features of defense style and clinical symptoms of eating attitude in patients with ano-rexia nervosa

Objective To investigate the relationship between the characteristics of psychological defense style and clinical symptoms of eating attitude in patients with anorexia nervosa patients. Methods Totally 92 ca-ses （ 46 cases of restricting type,46 cases of binge-eating/purging type,48 cases of early onset before 16 years old, 44 cases of late onset after 16 years old） meeting the Diagnostic and Statistical Manual of Mental Disorders,Forth Edition （ DSM-4） for anorexia nervosa （AN） were collected.92 gender-marriage-and education-matched normal cases in a psychiatric hospital were selected as the healthy control group（HC） .All were assessed with defensive style questionnaire（DSQ） and eating attitude test-26（EAT-26）.DSQ and EAT-26 were compared between AN and HC,between early onset of AN（ before 16 old years） and late onset of AN（ after 16 old years） ,and between AN-R and AN-P.Then correlation study was done for the AN. Results Compared with HC,AN showed higher scores in the immature defense,neurotic defense （（4.49±1.13）vs （3.55±0.93）,（4.33±0.76）vs （3.88±0.69）, P〈0.001）, and higher EAT-26 median total and factor scores of dieting scale items,bulimia＆amp;food preoccupation scale items, oral control subscale items （P〈0.01）.Compared with AN-R,AN-P showed higher scores in the immature defense （（4.49±1.03）vs （4.79±1.13）, P=0.01）,and higher EAT-26 median total and factor score of bulimia＆amp;food pre-occupation scale items （P〈0.05, P〈0.01）.The correlations between immature defense and EAT-26 total score,be-tween neurotic defense and EAT-26 total score were significant（ r=0.472, P〈0.001;r=0.315, P=0.002）. The correlations between immature defense and EAT-26 dieting score, between neurotic defense and EAT-26 dieting score were significant（ r=0.343, P〈0.001, r=0.257, P=0.014）.The correlations between immature defense and EAT-26 bulimia ＆amp; food preoccupation score,between neurotic defense and EAT-26 bulimia ＆amp; food pr