摘要
目的 分析双相情感障碍(BD)患者躯体症状、五态人格、情绪症状之间的关系,为BD的临床诊疗提供参考.方法 收集纳入BD患者的基本信息,采用自制躯体症状调查表调查出现频次＞20％的躯体症状,将其得分作为躯体症状评分,采用24项汉密尔顿抑郁量表(HAMD)评价患者抑郁症状,杨氏躁狂量表(YMRS)评价患者躁狂症状,汉密尔顿焦虑量表(HAMA)评价患者焦虑症状,五态人格测验量表评价患者五态人格,包括太阳人格、少阳人格、阴阳和平人格、少阴人格、太阴人格得分.采用复杂网络分析和线性回归模型分析躯体症状得分与五态人格得分、HAMD评分、YMRS评分、HAMA评分的相关性.结果 纳入BD患者269例,出现频次＞20％的躯体症状有19个,前3位是乏力(152例,56.51％)、口舌干燥(137例,50.93％)、喜冷饮(112例,41.64％),躯体症状评分为[7.0(0,10.0)]分;YMRS评分为[3.0(0,7.5)]分;HAMD评分为[11.0(5.0,18.0)]分;HAMA评分为[6.0(2.0,10.0)]分.五态人格中,太阳人格[10.0(7.0,13.0)]分;少阳人格[10.0(7.5,13.0)]分;阴阳平和人格[5.0(3.0,7.0)]分;少阴人格[13.0(10.0,16.0)]分;太阴人格[14.0(9.0,18.0)]分.复杂网络分析结果显示,BD患者躯体症状与太阴人格得分(r=0.23)、HAMD评分(r=0.21)、YMRS评分(r=0.13)呈正相关;太阴人格得分与HAMD评分呈正相关(r=0.17),与YMRS评分呈负相关(r=-0.03).线性回归模型分析结果显示,躯体症状得分与HAMD评分(β=0.138,P=0.003)、YMRS评分(β=0.128,P=0.006)、太阴人格得分(β=0.182,P＜0.001)呈正相关.结论 抑郁、躁狂、太阴人格是BD患者躯体症状的独立风险因素,五态人格中太阴人格与BD患者的躯体症状关系密切.
Abstract
Objective To analyze the relationship between somatic symptoms,five-state personality and emo-tional symptoms of bipolar disorder(BD),and to provide a reference for the clinical diagnosis and treatment of BD.Methods The basic information of the BD patients was collected,and the self-administered somatic symptom questionnaire was used to investigate the somatic symptoms with a frequency of＞20％,which were scored as the so-matic symptom scores;the 24-item Hamilton Depression Scale(HAMD)was used to evaluate the patients'depressive symptoms,the Young Mania Rating Scale(YMRS)was used to evaluate the patients'manic symptoms,the Hamilton Anxiety Scale(HAMA)was used to evaluate the patients'anxiety symptoms,and Five-State Personality Test was used to evaluate the patients'five-state personality(including taiyang personality,shaoyang personality,yin-yang balance personality,shaoyin personality,and taiyin personality).Network analysis and linear regression were used to analyse the correlation between the somatic symptom scores and the five-state personality scores,HAMD scores,YMRS scores,and HAMA scores.Results There were 269 patients with BD included,and 19 somatic symptoms with a frequency of＞20％,the top three being lack of strength(152 cases,56.51％),dry mouth(137 cases,50.93％),and preference for cold drinks(112 cases,41.64％),and the somatic symptom scores were[7.0(0,10.0)]points;the YMRS scores were[3.0(0,7.5)]points;the HAMD scores were[11.0(5.0,18.0)]points;and HAMA score was[6.0(2.0,10.0)]points.Among the five-state personalities,taiyang personality[10.0(7.0,13.0)]score;shaoyang personality[10.0(7.5,13.0)]score;yin-yang balance personality[5.0(3.0,7.0)]score;shaoyin personality[13.0(10.0,16.0)]score;and taiyin personality[14.0(9.0,18.0)]score.Complex network analysis showed that BD somatic symptoms were positively correlated with taiyin personality score(r=0.23),HAMD score(r=0.21),and YMRS score(r=0.13);taiyin personality score was positively correlated with HAMD score(r=0.17)and negatively correlated with YMRS score(r=-0.03).Linear regression analyses showed that somatic symptom scores were positively correlated with HAMD score(β=0.138,P=0.003),YMRS score(β=0.128,P=0.006),and taiyin personality scores(β=0.182,P＜0.001).Conclusion Dep ression,mania,and taiyin personality are independent risk factors for somatic symptoms in patients with BD,and taiyin personality is strongly associated with somatic symptoms in patients with BD.
基金项目
北京市医院管理中心重点医学专业发展计划(ZYLX202129)
北京市医院管理中心"登峰"人才培养计划(DFL201901901)
维普
万方数据