中国临床心理学杂志

慢性广泛性疼痛患者的临床特征、焦虑抑郁及述情障碍

单位：1. 济宁市第一人民医院心理门诊济宁 272100
2. 济宁市第一人民医院麻醉科济宁 272100

分类号：R395.2

出版年,卷(期):页码：2014,22(1):107-109

摘要：

目的:观察医学上不能解释的和可解释的慢性广泛性疼痛(CWP)患者的临床特征、述情障碍、焦虑抑郁水平,探讨焦虑抑郁与述情障碍在CWP患者的相关性。方法:118例CWP患者作为研究对象,由疼痛科医师和心理科医师对其作出临床诊断,应用疼痛视觉模拟评分标尺(VAS)、多伦多述情量表(TAS-20)、Spielberger特质焦虑问卷(TAI)和Beck抑郁自评问卷(BDI-13)进行测量。结果:45例医学上不能解释的CWP(CWP-MUE)患者被诊断为躯体形式障碍、抑郁症、焦虑症和适应障碍。31例CWP患者存在述情障碍。CWP-MUE患者的TAS-20总分、TAI和BDI-13评分均显著高于医学上可解释的CWP患者。述情障碍CWP患者的TAS-20总分、BDI-13和VAS评分显著高于非述情障碍CWP患者。CWP患者的TAS-20总分及DIF、DDF因子评分与BDI-13评分显著相关(r=0.294、0.303和0.248,P<0.01)。结论:CWP-MUE存在相应的精神病学诊断,具有更高的述情障碍发生率和抑郁焦虑水平。

Objective: To investigate the clinical characteristics of anxiety, depression and alexithymia in patients with chronic widespread pain(CWP) and the relationship between alexithymia and anxiety and depression. Methods: 118 patients with CWP were enrolled and tested by the Visual Analogue Scale(VAS) for pain intensity, the 20-item Toronto Alexithymia Scale(TAS-20), the Spielberger Trait Anxiety Inventory(TAI), and the 13-item Beck Depression Inventory(BDI-13). Results: 45 patients without medical accountings were diagnosed with somatoform disorder, depression, anxiety disorders and adjustment disorders. 31 patients with CWP were diagnosed as alexithymic. Compared to the CWP patients with medical accountings, the patients without medical accountings showed significantly higher scores in the total score of TAS-20, the TAI score and the BDI-13 score. Compared with the nonalexithymic patients with CWP, the alexithymic patients with CWP had significantly higher scores in the total score of TAS-20, the TAI score and the VAS score. The total score of TAS-20, the factor DIF score and the factor DDF score were significantly related to the BDI-13 score in patients with CWP(r= 0.294, 0.303 and 0.248 respectively,P<0.01). Conclusion: The CWP patients without medical accountings have higher prevalence of alexithymia and higher levels of anxiety and depression.

基金项目：

济宁市医药卫生科技项目(2012jnjc12)

作者简介：

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