白癜风患者心理健康状况及人格特征研究

发布时间：2018-07-06 12:06

本文选题：白癜风 + 心理健康　；参考：《第四军医大学》2007年硕士论文

【摘要】： 白癜风是一种以局限或广泛性色素脱失为典型临床表现的常见皮肤病,虽然有学者提出遗传、自身免疫、神经体液以及自身毒素等在其发病中起着重要作用,但目前病因和发病机制仍不十分清楚。自Engel提出新的医学模式——生物、心理、社会模式以来,精神心理因素在白癜风发生、发展中的作用倍受关注。由于皮肤与神经系统在发育上的共源,决定了心理因素与皮肤病之间存在密切联系,神经-内分泌-免疫系统的异常调节在白癜风中的作用已成共识。众多文献报道白癜风患者存在明显的精神心理疾病,患病率可高达25%,其中多数为适应性障碍,提示精神心理因素与白癜风的发生发展存在相互作用。但既往研究对白癜风患者心理健康及人格特征的观察不仅缺少系统性,而且还缺少与病情相关性的研究。因此,本研究旨在进一步探索白癜风患者心理健康现状、白癜风患者的人格特征、可能的易感因素,为白癜风患者的心理辅助治疗提供理论依据。研究目的通过对白癜风患者的发病状况、心理健康水平和人格特征进行调查,了解白癜风患者的心理健康现状和人格特征之间的关系,分析可能致病或加重的因素,为白癜风患者的心理辅助治疗提供理论依据。研究方法采用自编基本情况调查表、症状自评量表(SCL-90)、艾森克个性问卷量表(EPQ)、16项人格因素问卷量表(16PF),对我科就诊的137位白癜风患者分别进行基本情况、心理健康以及人格特征测查。将测查数据用SPSS13.0软件进行统计处理,统计方法有描述性统计、t检验、X2检验和方差分析。研究结果 1.不同性别白癜风患者在头颈、躯干、四肢、粘膜等发病部位以及皮损的单双侧分布等方面的差异均无统计学意义(P0.05),不同性别在皮损的单双侧分布以及发病部位等方面无明显差异。 2.与正常成人常模比较,白癜风患者SCL-90各因子得分均高于正常成人常模,除躯体化症状外各因子得分的差异均有统计学意义(P0.05)。 3.与病情处于活动期的白癜风患者比较,处于稳定期的患者SCL-90各因子得分均较低,除躯体化以外的SCL-90各因子得分的差异均有统计学意义(P0.05)。 4.重度白癜风患者SCL-90躯体化、敌对的因子得分高于轻、中度白癜风患者,其得分差异有统计学意义(P0.05)。 5.与正常成人常模比较,白癜风患者的稳定性、有恒性、敢为性等因子得分均低于常模,而怀疑性、幻想性、独立性等因子得分均高于常模,这些因子得分差异均具有统计学意义(P0.05)。 6.与正常成人常模比较,白癜风患者不论男性和女性,P量表(精神质)、E量表(神经质)和N量表(内-外向)的分值均高于常模组,得分差异均有统计学意义(P0.05)。 7.与白癜风皮损部位位于躯干、四肢等非暴露部位以及全身泛发的患者相比,皮损单纯位于头、面、颈等暴露部位的白癜风患者P量表(精神质)、N量表(神经质)、L因素(怀疑性)和N因素(世故性)的得分显著高于前二者,而C因素(稳定性)的得分低于前二者,经方差分析,这些因素的差异具有统计学意义(P0.05)。 8.白癜风患者16PF中的C因素(稳定性)与SCL-90中除了躯体化、敌对、偏执外的其他6因子均呈负相关;H因素(敢为性)与SCL-90中除了躯体化、敌对、恐怖、偏执、精神病性外其他4因子均呈负相关;O因素(忧虑性)与SCL-90中除了躯体化、强迫症状、敌对、偏执、精神病性外其他4因子均呈正相关;L因素(怀疑性)与SCL-90中除了躯体化、敌对、偏执呈正相关外与SCL-90其余各因子均无相关性;Q4因素(紧张性)与SCL-90中除了躯体化外其他8因子均呈正相关;而A因素(乐群性)、B因素(智慧性)、E因素(影响性)、G因素(有恒性)、I因素(情感性)、M因素(幻想性)、N因素(世故性)及Q1因素(变革性)与SCL-90各因子均无相关性。 9.白癜风患者EPQ中的P(精神质)因子与SCL-90中除了躯体化、强迫症状、敌对、精神病性外的其他5因子均呈正相关;N(神经质)因子与SCL-90中除了敌对外其他8因子均呈正相关;E(内外向)因子除了与SCL-90中的强迫症状呈负相关外,与其他8因子均无相关性;L(掩饰性)因子除了与SCL-90中的精神病性呈负相关外,与其他8因子均无相关性。研究结论 1.不同性别白癜风患者在发病部位以及皮损的单双侧分布等方面无明显差异;与正常成人常模比较,白癜风患者心理健康状况整体较差;与稳定期的患者相比,活动期患者负性情绪更多,在强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性等症状方面更明显;白癜风患者心理健康状况与病情的发展及皮损面积相关。 2.白癜风患者不论男性、女性,P量表(精神质)、E量表(内-外向)、N量表(神经质)及在L因素(怀疑性)、M因素(幻想性)的分值都高于常模组,而在C因素(稳定性)、G因素(有恒性)等方面均低于常模组,在人格结构中,表现为易焦虑、紧张、担忧、郁郁不乐、忧心忡忡;情绪起伏较大,渴望刺激和冒险;对人抱有敌意,难以适应外部环境,与他人不能友好相处;固执、倔强、喜欢寻衅、缺乏同情心等人格特征。 3.稳定性差、缺乏自信、忧虑性高、紧张性高及怀疑性高的患者在强迫症状、人际关系敏感、抑郁、焦虑、恐怖、躯体化、敌对、精神病性等方面的负性情绪明显。而乐群性、智慧性、影响性、有恒性、情感性、幻想性、世故性、变革性等因子与SCL-90各因子均无相关性,说明白癜风患者无论以上各人格特征有无差异,其出现各种心理症状的机会均等。
[Abstract]:Vitiligo is a common dermatosis with localized or extensive pigment loss as a typical clinical manifestation. Although some scholars have proposed heredity, autoimmunity, neurohumus and self toxin, it plays an important role in its pathogenesis, but the etiology and pathogenesis are still not very clear. A new medical model, biology, psychology, is put forward from Engel. Since the social model, psycho psychological factors have attracted much attention in the development of vitiligo. Because of the common development of the skin and the nervous system, there is a close relationship between the psychological factors and dermatosis. The role of the abnormal regulation of the neuroendocrine immune system in the white purpura has become a common understanding. The patients with purpura wind have obvious mental and psychological diseases, the prevalence rate can be as high as 25%, most of which are adaptive disorders, suggesting the interaction between psycho psychological factors and the occurrence and development of vitiligo. However, previous studies on the psychological health and personality characteristics of vitiligo patients are not only short of systematic, but also lack of research on the correlation with the disease. Therefore, this study aims to further explore the mental health status of patients with vitiligo, the personality characteristics of patients with vitiligo, possible susceptibility factors, and provide theoretical basis for the psychological adjuvant treatment of vitiligo patients.
research objective
Through the investigation of the status of the patients with vitiligo, the level of mental health and personality characteristics, the relationship between the mental health status and personality characteristics of patients with vitiligo is understood, and the factors that may cause disease or aggravation are analyzed to provide a theoretical basis for the psychological adjuvant treatment of vitiligo patients.
The method used the self-made basic situation questionnaire, the symptom checklist (SCL-90), the Eysenck Personality Questionnaire (EPQ) and the 16 Personality Factor Questionnaire (16PF). The basic situation, mental health and personality characteristics of 137 vitiligo patients in our department were examined. The data were processed by SPSS13.0 software. Descriptive statistics, t test, X2 test and ANOVA were used.
Research results
1. there was no significant difference between different sex vitiligo patients in the head, neck, trunk, limbs, mucous membrane, and the single and bilateral distribution of skin lesions (P0.05). There was no significant difference in the single and bilateral distribution of the skin lesions and the location of the lesions.
2. compared with normal adult norm, the scores of SCL-90 factors in patients with vitiligo were higher than those of normal adults. There were significant differences in the scores of all factors except somatization symptoms (P0.05).
3. compared with the patients with vitiligo in the active period, the scores of SCL-90 factors in the patients in the stable period were lower, and the differences in the scores of all the factors except the somatization were statistically significant (P0.05).
4. the scores of SCL-90 somatization and hostility in patients with severe vitiligo were higher than those in mild and moderate vitiligo patients, and the difference was statistically significant (P0.05).
5. compared with normal adult norm, the scores of the factors such as stability, persistence, dares and other factors in vitiligo were lower than the norm, but the scores of suspicion, fantasy and independence were all higher than those of the normal model, and the differences of these factors were all statistically significant (P0.05).
6. compared with normal adult norm, the scores of the P scale (psychoticism), the E scale (neuroticism) and the N scale (internal extrovert) were all higher than those of the normal group, and the difference in score was statistically significant (P0.05).
7. compared with the patients with vitiligo skin lesions, such as the trunk, the extremities and other non exposed parts, and the generalized patients, the P scale (psychoticism), the N scale (neuroticism), the L factor (skepticism) and the N factor in the exposed parts of the head, face and neck were significantly higher than those of the first two, and the scores of the C factor (stability) were significantly higher than those in the head, face and neck. The difference between these factors was statistically significant (P0.05), which was lower than the first two.
8. the C factor (stability) in 16PF of patients with vitiligo was negatively correlated with other 6 factors except somatization, hostility and paranoid, while H factors were negatively correlated with other 4 factors except somatization, hostility, terror, paranoia and psychosis in SCL-90; O factors (anxiety) and SCL-90 in addition to somatization, compulsion, hostility, Paranoia and psychosis were positively correlated with other 4 factors; L factor (scepticism) had no correlation with other factors of SCL-90 except somatization, hostility and paranoia in SCL-90; Q4 factor (tension) was positively correlated with other factors except somatization in SCL-90; A factor (Music Group), B factor (Intelligence), E factor (influence) Sex, G factors (persistence), I factor (emotional), M factor (Fantasy), N factor (sophistication) and Q1 factor (transformational) had no correlation with SCL-90 factors.
9. the P (psychotic) factor of EPQ in patients with vitiligo was positively correlated with the somatization, compulsive symptoms, hostility and other 5 factors outside the psychosis; N (neuroticism) factor was positively correlated with the other 8 factors of the enemy, and the E (internal and external) factor was negatively related to the compulsive symptoms in SCL-90, and all the other 8 factors were related. There was no correlation; L (concealment factor) was negatively correlated with psychosis in SCL-90, but was not correlated with other 8 factors.
research conclusion
1. different sex vitiligo patients have no significant difference in the location of the disease and the single and bilateral distribution of the skin lesions. Compared with the normal adult norm, the mental health status of the patients with vitiligo is poor. Compared with those in the stable period, the patients in the active stage have more negative emotion, in the symptoms of compulsion, interpersonal sensitivity, depression, anxiety, hostility, and terror, Paranoid, psychotic and other symptoms are more obvious; mental health status of vitiligo patients is related to the development of the disease and the area of lesions.
2. in patients with vitiligo, both male, female, P scale (mental quality), E scale (internal extroversion), N scale (neuroticism) and L factor (suspicion), M factor (Fantasy) were all higher than the norm group, while the C factor (stability), G factor (identity) were lower than the norm group, and in the personality structure, it showed anxiety, tension, worry, and depression. Happy, worried; emotional ups and downs, eager to stimulate and adventure; to be hostile to people, difficult to adapt to the external environment, and others can not be friendly with others; stubborn, stubborn, like a defiance, lack of compassion and other personality characteristics.
3. poor stability, lack of self-confidence, high anxiety, high tension and high skepticism, negative emotions in compulsive symptoms, interpersonal sensitivity, depression, anxiety, horror, somatization, hostility, psychosis, and other factors such as music, intelligence, influence, identity, emotion, fantasy, sophistication, change and other factors and SCL-90 causes There was no correlation between them, indicating that vitiligo patients had equal chances of psychological symptoms regardless of their personality characteristics.
【学位授予单位】：第四军医大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R758.41;R395

【引证文献】