摘要
目的探索人格特质及家庭功能对双相情感障碍患者冲动性的影响。方法选择双相情感障碍患者151例,采用汉密尔顿抑郁量表(HAMD)、杨氏躁狂评定量表(YMRS)、简明精神病评定量表(BPRS)、艾森克人格问卷简式量表中国版(EPQ-RSC)、家庭亲密度与适应性量表中文版(FACESII-CV)、冲动性量表(BIS)收集数据并进行分析。结果入组患者中独生子女BIS注意力冲动性、无计划冲动性得分高于非独生子女(P<0.05)。不同的婚姻状况的患者行动冲动性得分比较差异有统计学意义(P<0.05),经事后检验,离异或丧偶的患者行动冲动性得分高于已婚患者(P<0.05)。BIS总分及无计划冲动性因子分与YMRS、BPRS总分均呈正相关(P<0.05),BIS注意力冲动性、无计划冲动性因子分与HAMD激越因子分、BPRS总分均呈正相关(P<0.05),BIS行动冲动性因子分与BPRS总分呈正相关(P<0.01)。BIS总分及无计划冲动性因子分与EPQ-RSC精神质、神经质均呈正相关(P<0.05),与外倾性、掩饰性均呈负相关(P<0.01);注意力冲动性、行动冲动性与神经质呈正相关(P<0.05),与掩饰性呈负相关(P<0.01);另外,行动冲动性与精神质呈现正相关(P<0.05)。BIS总分及无计划冲动性因子分与FACESII-CV亲密度、适应性均呈负相关(P<0.01),行动冲动性与亲密度呈负相关(P<0.05)。分层回归分析结果显示,在控制了患者本身的精神症状及是否为独生子女后,EPQ-RSC精神质、外倾性、掩饰性对双相情感障碍患者无计划冲动性解释的变异量增加了15%(P<0.05),家庭亲密度对该患者群体无计划冲动性解释的变异量增加了4.5%(P<0.01)。结论除患者本身精神症状外,精神质、外倾性、掩饰性、家庭亲密度是双相情感障碍患者无计划冲动性的重要影响因素。精神科医生在临床诊疗过程中,应重视心理干预治疗,辅助改善患者预后。
Objective To explore the influences of personality trait and family function on impulsivity in patients with bipolar disorder.Methods 151 patients with bipolar disorder were selected and assessed with Hamilton Depression Scale(HAMD),Young Manic Rating Scale(YMRS),Brief Psychiatric Rating Scale(BPRS),Eysenck Personality Questionnaire-Revised,Short Scale For Chinese(EPQ-RSC),Family Adaptability and Cohesion Scale-Chinese version(FACESII-CV)and Barratt Impulsive-ness Scale(BIS).Results The factor scores of attentional impulsiveness and nonplanning impulsiveness of BIS in patients from one-child families were significantly higher than those from non-only child families(P<0.05).There existed significant differences in the factor scores of motor impulsiveness of BIS among patients with different marital status(P<0.05),and divorced or widowed patients showed higher scores than the married ones(P<0.05).The total score and factor score of nonplanning impulsiveness of BIS were positively correlated with the total scores of YMRS and BPRS(P<0.05).The factor scores of attentional impulsiveness and nonplanning impulsiveness of BIS were positively correlated with agitation factor score of HAMD and the total score of BPRS(P<0.05).The motor impulsiveness factor score of BIS was positively correlated with the total score of BPRS(P<0.01).The total score and factor score of nonplanning impulsiveness of BIS were positively correlated with factor scores of psychoticism and neuroticism of EPQ-RSC(P<0.05),and negatively correlated with factor scores of extroversion and lying of EPQ-RSC(P<0.01).The factor scores of attentional impulsiveness and motor impulsiveness were positively correlated with neuroticism factor score(P<0.05),and negatively correlated with lying factor score(P<0.01).The motor impulsiveness factor score was positively correlated with psychoticism factor score(P<0.05).The total score and factor score of nonplanning impulsiveness of BIS were negatively correlated with factor scores of family intimacy and adaptability of FACESII-CV(P<0.01),and motor impulsiveness factor score was negatively correlated with family intimacy factor score(P<0.05).Hierarchical regression analysis showed that after controlling the patients’own mental symptoms and whether they were the only child or not,the variance of psychoticism,extroversion and lying of EPQ-RSC on the explanation of nonplanning impulsiveness in patients with bipolar disorder increased by 15%(P<0.05),and the variance of family intimacy on the explanation of nonplanning impulsiveness in patients with bipolar disorder increased by 4.5%(P<0.01).Conclusion In addition to mental symptoms,psychoticism,extroversion,lying and family intimacy are important influencing factors for nonplanning impulsiveness in patients with bipolar disorder.It is suggested that psychiatrists should pay attention to psychological intervention to improve the prognosis of patients with bipolar disorder.
作者
刘畅畅
陈方煜
戴媛媛
杨稳稳
LIU Changchang;CHEN Fangyu;DAI Yuanyuan(Department of Psychology, School of Humanities and Management, Wannan Medical College, Wuhu 241002, China)
出处
《精神医学杂志》
2021年第5期432-435,共4页
Journal of Psychiatry
基金
芜湖市卫生健康委员会课题研究项目(编号:kjxm2019-02)。
