恶劣心境患者述情障碍与自主神经功能的相关研究

目的:探讨恶劣心境患者的人格特质、述情障碍与自主神经功能心理生理反应的相关机制。方法:采用多伦多述情障碍量表中文版(TAS-20-C)及心理健康测查表(PHI)对42例恶劣心境患者组(DD组)、33例重性抑郁症患者组(MD组)及30例健康对照组(NC组)进行述情障碍和心理健康水平和人格特质测定,并分析短时(5min)心率变异性(HRV),评定自主神经功能。结果:DD组TAS-20-C各因子得分及总分显著高于NC组(P<0.01),因子Ⅰ、因子Ⅱ及总分均明显高于MD组(P<0.01或P<0.05);DD组PHI量表躯体化、焦虑、病态人格及疑心因子分明显高于MD组(P<0.01或P<0.05);DD组HRV频谱指标中SDNN、PNN50及HF较MD及NC组均显著下降(P<0.01或P<0.05),LF∕HF较MD及NC组均明显升高(P<0.05);TAS-20-C总分及因子Ⅰ与躯体化、焦虑、病态人格、疑心均相关(︱r︱=0.25～0.38,0.40～0.44,0.47～0.59,0.43～0.42,P<0.01或P<0.05),因子Ⅱ与焦虑及变态人格相关(︱r︱=0.31,0.31,P<0.05);躯体化及焦虑与SDNN、VLF及LF均相关(︱r︱=0.26～0.27,0.39～0.27;︱r︱=0.36～0.28,P<0.05或P<0.01)。结论:恶劣心境患者存在明显的述情障碍,其人格特质可能导致患者焦虑程度更高,伴自主神经功能紊乱。

A correlative study of alexithymia and autonomic nervous function in patients with dysthymic disorder

Objective:To explore the correlations between personality character,alexithymia and nervous function in patients with dysthymic disorder.Method:TAS-20-C、PHI and short-term heart rate variability were measured in 42 patients with dysthymic disorder(DD group),33 patients with major depressive disorder(MD group)and 30 heathty controls(NC group).Results:The total and subscale scores of TAS-20-C of DD group are higher than the NC group(P<0.01),DD group showed higher total and factorⅠas well as Ⅱscore of TAS-20-C than the MD group(P<0.01 or P<0.05).DD group gained higher score in the somatization,anxiety,psychopathic deviate and hypomania than the MD group(P<0.05 or P<0.01).The SDNN、PNN50 and HF of DD group were significantly lower than MD and NC groups,the LF and LF/HF were higher than other two groups.(P<0.05).The correlation between the TAS-20-C total score,factorⅠand somatization,anxiety,psychopathic deviate,hypomania were significant(︱r︱=0.25～0.38,0.40~0.44,0.47～0.59,0.43～0.42,P<0.01 or P<0.05),the score of faceorⅡwas correlated with anxiety and psychopathic deviate(︱r︱=0.31,0.31,P<0.05);the somatization and anxiety were correlated with SDNN、VLF and LF(︱r︱=0.26～0.27,0.39～0.27;︱r︱=0.36～0.28,P<0.05 or P<0.01).Conclusion:Alexithymia,anxiety produced by their personality characters and autonomic nervous system dysfunction are found in patients with dysthymic disorder.