不同强迫症症状群与中医五态人格及其完美主义倾向研究

发布时间：2018-05-07 04:28

本文选题：强迫症 + 中医五态人格　；参考：《新乡医学院》2017年硕士论文

【摘要】：背景强迫症(obsessive-compulsive disorder,OCD)是一种临床上主要表现为强迫思维、强迫行为和/或强迫冲动等症状的神经症。患者明知道这些强迫症状不必要、不合理,但却无法摆脱和控制他们,因而感到焦虑和烦躁。强迫思维和行为是一种令人讨厌的症状,常常会使患者的工作、人际交往等各个方面的发展受到明显影响,严重者还会使患者的各项社会功能受损,给个人、家庭及社会均造成极大伤害。其终生患病率为1%~3%,强迫症的发病率正呈现出逐年上升的趋势。中医认为,强迫症是由情志失调导致气机不畅,脏腑功能失调所引起的一类病症,常见病机有肝郁化火、肝郁脾虚、心脾两虚、肝郁痰阻、气虚血瘀等。属于“郁病”范畴。随着传统文化在中国的重视及心理学在神经症发病中的作用越来越多,中医研究及强迫症患者的人格特征越来越受到关注,而目前该方面研究较少,尤其是强迫症患者的中医五态人格特征分类研究几乎空白。因此对强迫症患者的中医五态人格特征及完美主义倾向研究有重要的理论和实际意义。目的1.分析不同强迫症症状群患者的中医五态人格及其完美主义倾向特点,旨在找出他们之间的关联性;2.探讨不同强迫症症状群与中医五态人格特征及完美主义之间的关系,以期为不同症状群的强迫症的临床诊疗开辟新的途径。方法本研究采用横断面调查法,实验组:选取2015年10月至2016年11月在洛阳市精神卫生中心、河南省洛阳荣康医院和洛阳市第五人民医院精神科门诊、心理门诊就诊及住院部收治的经知情同意后参加本次研究测试的120例强迫症患者为研究对象,入组患者均符合《国际疾病分类与诊断标准》(第10版)(ICD-10)强迫症的诊断标准,其中男55例,女65例,年龄范围18-45岁。同时对照组招募114例健康志愿者,男57例,女57例,年龄范围19-48岁。测试评估时采用的研究工具为:一般情况问卷、中医五态人格量表、中文Frost完美主义问卷(CFMPS)、耶鲁-布朗强迫症严重程度量表等作为研究工具,对性别、年龄、文化程度等维度上的差异进行统计分析,并分别分析强迫症强迫思维型、强迫行为型和强迫思维与强迫行为混合型患者人格在中医五态人格的分布规律及其完美主义心理倾向。全部资料采用SPSS19.0统计软件进行数据处理。结果1.不同强迫症症状群患者的一般情况分析强迫思维型强迫症组强迫程度量表分数显著高于对照组(t=19.062,P=0.000),差异有统计学意义;强迫行为型强迫症组强迫程度量表分数显著高于对照组(t=14.856,P=0.000),差异有统计学意义;强迫思维与强迫行为混合型强迫症组强迫程度量表分数显著高于对照组(t=32.751,P=0.000),差异有统计学意义。三种类型强迫症组人口学变量上无差异,即性别、年龄、民族、职业、婚姻状况、文化程度等相关因素对患者组强迫量表得分无显著影响。2.不同强迫症症状群与中医五态人格的关系分析强迫思维型强迫症组五态人格在太阳(t=-5.958,P=0.000)、少阳(t=-7.738,P=0.000)、阴阳平和(t=-12.925,P=0.000)3个维度得分均低于对照组,差异有统计学意义,在太阴(t=9.713,P=0.000)及少阴(t=19.933,P=0.000)维度得分高于对照组,差异有统计学意义;强迫行为型强迫症组五态人格在少阳(t=-12.425,P=0.000)、阴阳平和(t=-13.222,P=0.000)2个维度得分均低于对照组,差异有统计学意义,在太阳(t=7.141,P=0.000)、太阴(t=19.094,P=0.000)及少阴(t=8.298,P=0.000)维度得分高于对照组,差异有统计学意义;强迫思维与强迫行为混合型强迫症组五态人格在少阳(t=-8.981,P=0.000)、阴阳平和(t=-15.777,P=0.000)2个维度得分均低于对照组,差异有统计学意义,在太阳(t=11.263,P=0.000)、太阴(t=21.538,P=0.000)及少阴(t=10.120,P=0.000)维度得分高于对照组,差异有统计学意义。强迫思维型强迫症患者组女性较男性在少阴维度得分差异有统计学意义(t=2.378,P=0.023),未婚较已婚者在太阳维度得分差异有统计学意义(t=-2.462,P=0.019)。强迫程度与阴阳平和(r=-0.610,P=0.000)、少阳(r=-0.450,P=0.000)之人的个性特点之间呈显著负相关,强迫程度与少阴(r=0.510,P=0.000)、太阴(r=0.697,P=0.000)、太阳(r=0.347,P=0.000)之人的个性特点之间显著的正相关。其余不同组患者在五个维度得分均无差异性(P0.05)。3.不同强迫症症状群与追求完美的关系分析强迫思维型强迫症组的完美主义得分(t=22.674,P=0.000)高于对照组,差异有统计学意义;强迫行为型强迫症组的完美主义得分(t=24.438,P=0.000)高于对照组,差异有统计学意义;强迫思维与强迫行为混合型强迫症组的完美主义得分(t=25.950,P=0.000)高于对照组,差异有统计学意义。强迫行为型强迫症组在性别组别上的因子得分差异具有显著性(t=4.287,P=0.000),综合一起分析,强迫严重程度和追求完美呈显著正相关(r=0.714,P=0.000)。4.不同强迫症症状群五态人格特点与完美主义特点相关性分析强迫行为型组五态人格少阳维度与完美主义特点(r=-0.376,P=0.020)呈负相关;混合型组太阳维度与完美主义特点(r=0.379,P=0.010)呈显著正相关。结论1.在中医五态人格分类中,同时具有太阳人格及太阴人格及具有太阴人格、少阴人格的人更易患强迫症,强迫症患者人格中均不符合少阳人格、阴阳平和人格。性格维度倾向于太阴或少阴、太阳维度的人出现强迫的几率较大。同为少阴性格之人女性较男性发生强迫思维型强迫症的风险更高,与已婚者相比较,同为太阳人格的未婚者同为太阳性格之人未婚者较已婚者发生强迫思维型强迫症的风险更高。2.不同强迫症症状群(强迫思维型、强迫行为型、强迫性思维与行为混合型)与完美主义均具有较显著关系,且强迫症严重程度与完美主义强度呈正相关。强迫行为型强迫症组患者中女性表现出明显的完美主义倾向。
[Abstract]:Obsessive-compulsive disorder (OCD) is a neurosis which is mainly manifested in symptoms of forced thinking, compulsive behavior and / or compulsion. Patients know that these compulsive symptoms are not necessary and unreasonable, but they can not get rid of and control them, because they feel anxious and irritable. Compulsive thinking and behavior is a kind of order. People hate symptoms, often make the patient's work, interpersonal communication and other aspects of the development of the development are obviously affected, serious people will also make the social function of the patient, to the individual, family and society all cause great harm. The lifetime prevalence rate is 1%~3%, the incidence of obsessive-compulsive disorder is increasing year by year. Chinese medicine thinks, strong The disease is a kind of disease caused by the disorder of the Qi and the dysfunction of the viscera. The common pathogenesis is liver depression fire, liver depression and spleen deficiency, two deficiency of the heart and spleen, stagnation of liver and phlegm, Qi deficiency and blood stasis. The personality characteristics of the patients with obsessive-compulsive disorder are becoming more and more concerned, but at present there are few studies in this area, especially in the patients with obsessive-compulsive disorder, the classification of the personality characteristics of the five state of Chinese medicine is almost blank. Therefore, it has important theoretical and practical significance to study the characteristics of the five state personality of Chinese medicine and the perfectionism tendency of the OCD patients. The five state personality of Chinese medicine and its perfectionist tendencies in the patients with symptomatic group are designed to find the relationship between them; 2. to explore the relationship between the symptom groups of different obsessive-compulsive disorder and the character of five state of traditional Chinese medicine and perfectionism, in order to open up a new way for the clinical treatment of the obsessive-compulsive disorder with different symptom groups. Surface investigation method and experimental group: 120 cases of obsessive-compulsive disorder were selected from October 2015 to November 2016 in Luoyang mental health center, Henan Luoyang Rong Kang Hospital and Luoyang City Fifth People's hospital psychiatric clinic, psychological outpatient consultation and inpatient department. The criteria for the diagnosis of obsessive-compulsive disorder (ICD-10) (ICD-10), including 55 men, 65 women and 18-45 years of age, were recruited in 114 healthy volunteers, 57 men, 57 women and 19-48 years of age. The general situation questionnaire, Chinese medicine five personality scale, Chinese F The Rost perfectionist questionnaire (CFMPS), Yale Brown obsessive-compulsive severity scale, etc. were used as research tools to analyze the differences in gender, age, and educational level, and analyze the distribution of the personality of obsessive compulsive thinking, compulsive behavior and forced thinking and forced behavior in the five state of Chinese medicine. Regularity and psychological tendency of perfectionism. All data were processed by SPSS19.0 software. Results 1. the general situation of patients with different obsessive-compulsive disorder symptoms group analysis of obsessive-compulsive obsessive compulsive degree scale score was significantly higher than that of the control group (t=19.062, P=0.000), the difference was statistically significant; compulsive obsessive compulsive disorder group was strong The score of the forced course measurement was significantly higher than that of the control group (t=14.856, P=0.000), and the difference was statistically significant. The Obsessive-Compulsive Scale score of the obsessive and compulsive obsessive compulsive disorder group was significantly higher than that of the control group (t=32.751, P=0.000), and the difference was statistically significant. There was no difference in the demographic variables between the three types of obsessive-compulsive disorder group, that is, sex, age, and nationality, Occupational, marital status, cultural degree and other related factors have no significant influence on the score of.2. in patients with obsessive-compulsive disorder (t=-5.958, P=0.000), Shaoyang (t=-7.738, P =0.000), and t=-12.925, P=0.000 (t=-12.925, P=0.000) in the group of obsessive compulsive obsessive compulsive disorder Compared with the control group, the difference was statistically significant. The scores of t=9.713, P=0.000 and t=19.933, P=0.000 were higher than those in the control group, and the difference was statistically significant. The scores of the five state personality in the obsessive-compulsive obsessive compulsive disorder group were lower than those of the control group in the 2 dimensions of Shaoyang (t=-12.425, P=0.000), Yin Yang Ping and (t=-13.222, P=0.000). The difference was statistically significant. Meaning, the scores in the t=7.141, P=0.000, t=19.094, P=0.000 and t=8.298, P=0.000 (t=8.298, P=0.000) were higher than those of the control group, and the difference was statistically significant. The scores of the five state personality in the mixed obsessive-compulsive disorder group (t=-8.981, P=0.000), Yin Yang and t=-15.777, P=0.000 (t=-15.777, P=0.000) were all lower than the control group, the difference was lower than that of the control group. There were statistical significance in the dimensions of the dimensions of the sun (t=11.263, P=0.000), t=21.538, P=0.000 and t=10.120, P=0.000 (t=10.120, P=0.000), and the difference was statistically significant. There was a statistically significant difference between the women of the obsessive-compulsive obsessive compulsive disorder group and the male (t=2.378, P=0.023), and the unmarried married people were in the sun dimension. The differences were statistically significant (t=-2.462, P=0.019). There was a significant negative correlation between the degree of compulsion and the personality characteristics of people with r=-0.610, P=0.000 and r=-0.450 (P=0.000). The degree of obsessive compulsion was positively correlated with the personality characteristics of the people of less Yin (r=0.510, P=0.000), Tai Yin (r=0.697, P= 0), and the sun (r=0.347, P=0.000). There was no difference in the scores of five dimensions (P0.05) in different groups of patients (.3.) and the relationship between the symptoms of obsessive-compulsive disorder and the pursuit of perfection. The perfectionism score of the obsessive-compulsive obsessive compulsive disorder group (t=22.674, P=0.000) was higher than that of the control group, the difference was statistically significant; the perfectionism score of the obsessive-compulsive group (t=24.438, P=0.000) was higher than that of the obsessive-compulsive obsessive compulsive disorder group. The difference was statistically significant in the control group; the perfectionism score (t=25.950, P=0.000) in the obsessive and compulsive obsessive compulsive disorder group was higher than that of the control group. The difference was statistically significant. The scores of factors in the group of obsessive-compulsive obsessive compulsive obsessive compulsive disorder were significant (t=4.287, P=0.000), combined analysis, and forced severity. The correlation analysis between the five state personality characteristics and perfectionism characteristics of the symptoms group of different obsessive-compulsive disorder (r=0.714, P=0.000).4., the analysis of the five state personality Shaoyang dimension of the compulsive behavior group was negatively correlated with the perfectionism (r=-0.376, P=0.020), and the mixture group too Yang dimension and perfectionism (r=0.379, P=0.010) showed significant positive Conclusion 1. in the classification of five state personality of Chinese medicine, there are both the personality of the sun and the Taiyin personality and the Taiyin personality. The people with the personality of the less Yin are more susceptible to obsessive-compulsive disorder. The personality of the patients with obsessive-compulsive disorder does not conform to the personality of Shaoyang, Yin and Yang and the personality. The risk of compulsive obsessive compulsive obsessive compulsive disorder in women with less Yin character is higher than that of men. Compared with married people, the risk of obsessive compulsive obsessive compulsive disorder with the same sun personality as unmarried and unmarried people of the sun personality is higher in.2. different obsessive-compulsive disorder group (forced thinking, compulsive behavior, compulsive thinking). It has a significant relationship with perfectionism, and the severity of obsessive-compulsive disorder has a positive correlation with perfectionism intensity. The women in obsessive compulsive obsessive compulsive disorder show a clear tendency to perfectionism.

【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.7

【参考文献】