本文選題：白癜風 + 心理健康　； 參考：《第四軍醫(yī)大學》2007年碩士論文

【摘要】： 白癜風是一種以局限或廣泛性色素脫失為典型臨床表現(xiàn)的常見皮膚病,雖然有學者提出遺傳、自身免疫、神經(jīng)體液以及自身毒素等在其發(fā)病中起著重要作用,但目前病因和發(fā)病機制仍不十分清楚。自Engel提出新的醫(yī)學模式——生物、心理、社會模式以來,精神心理因素在白癜風發(fā)生、發(fā)展中的作用倍受關(guān)注。由于皮膚與神經(jīng)系統(tǒng)在發(fā)育上的共源,決定了心理因素與皮膚病之間存在密切聯(lián)系,神經(jīng)-內(nèi)分泌-免疫系統(tǒng)的異常調(diào)節(jié)在白癜風中的作用已成共識。眾多文獻報道白癜風患者存在明顯的精神心理疾病,患病率可高達25%,其中多數(shù)為適應(yīng)性障礙,提示精神心理因素與白癜風的發(fā)生發(fā)展存在相互作用。但既往研究對白癜風患者心理健康及人格特征的觀察不僅缺少系統(tǒng)性,而且還缺少與病情相關(guān)性的研究。因此,本研究旨在進一步探索白癜風患者心理健康現(xiàn)狀、白癜風患者的人格特征、可能的易感因素,為白癜風患者的心理輔助治療提供理論依據(jù)。 研究目的 通過對白癜風患者的發(fā)病狀況、心理健康水平和人格特征進行調(diào)查,了解白癜風患者的心理健康現(xiàn)狀和人格特征之間的關(guān)系,分析可能致病或加重的因素,為白癜風患者的心理輔助治療提供理論依據(jù)。 研究方法采用自編基本情況調(diào)查表、癥狀自評量表(SCL-90)、艾森克個性問卷量表(EPQ)、16項人格因素問卷量表(16PF),對我科就診的137位白癜風患者分別進行基本情況、心理健康以及人格特征測查。將測查數(shù)據(jù)用SPSS13.0軟件進行統(tǒng)計處理,統(tǒng)計方法有描述性統(tǒng)計、t檢驗、X2檢驗和方差分析。 研究結(jié)果 1.不同性別白癜風患者在頭頸、軀干、四肢、粘膜等發(fā)病部位以及皮損的單雙側(cè)分布等方面的差異均無統(tǒng)計學意義(P0.05),不同性別在皮損的單雙側(cè)分布以及發(fā)病部位等方面無明顯差異。 2.與正常成人常模比較,白癜風患者SCL-90各因子得分均高于正常成人常模,除軀體化癥狀外各因子得分的差異均有統(tǒng)計學意義(P0.05)。 3.與病情處于活動期的白癜風患者比較,處于穩(wěn)定期的患者SCL-90各因子得分均較低,除軀體化以外的SCL-90各因子得分的差異均有統(tǒng)計學意義(P0.05)。 4.重度白癜風患者SCL-90軀體化、敵對的因子得分高于輕、中度白癜風患者,其得分差異有統(tǒng)計學意義(P0.05)。 5.與正常成人常模比較,白癜風患者的穩(wěn)定性、有恒性、敢為性等因子得分均低于常模,而懷疑性、幻想性、獨立性等因子得分均高于常模,這些因子得分差異均具有統(tǒng)計學意義(P0.05)。 6.與正常成人常模比較,白癜風患者不論男性和女性,P量表(精神質(zhì))、E量表(神經(jīng)質(zhì))和N量表(內(nèi)-外向)的分值均高于常模組,得分差異均有統(tǒng)計學意義(P0.05)。 7.與白癜風皮損部位位于軀干、四肢等非暴露部位以及全身泛發(fā)的患者相比,皮損單純位于頭、面、頸等暴露部位的白癜風患者P量表(精神質(zhì))、N量表(神經(jīng)質(zhì))、L因素(懷疑性)和N因素(世故性)的得分顯著高于前二者,而C因素(穩(wěn)定性)的得分低于前二者,經(jīng)方差分析,這些因素的差異具有統(tǒng)計學意義(P0.05)。 8.白癜風患者16PF中的C因素(穩(wěn)定性)與SCL-90中除了軀體化、敵對、偏執(zhí)外的其他6因子均呈負相關(guān);H因素(敢為性)與SCL-90中除了軀體化、敵對、恐怖、偏執(zhí)、精神病性外其他4因子均呈負相關(guān);O因素(憂慮性)與SCL-90中除了軀體化、強迫癥狀、敵對、偏執(zhí)、精神病性外其他4因子均呈正相關(guān);L因素(懷疑性)與SCL-90中除了軀體化、敵對、偏執(zhí)呈正相關(guān)外與SCL-90其余各因子均無相關(guān)性;Q4因素(緊張性)與SCL-90中除了軀體化外其他8因子均呈正相關(guān);而A因素(樂群性)、B因素(智慧性)、E因素(影響性)、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(變革性)與SCL-90各因子均無相關(guān)性。 9.白癜風患者EPQ中的P(精神質(zhì))因子與SCL-90中除了軀體化、強迫癥狀、敵對、精神病性外的其他5因子均呈正相關(guān);N(神經(jīng)質(zhì))因子與SCL-90中除了敵對外其他8因子均呈正相關(guān);E(內(nèi)外向)因子除了與SCL-90中的強迫癥狀呈負相關(guān)外,與其他8因子均無相關(guān)性;L(掩飾性)因子除了與SCL-90中的精神病性呈負相關(guān)外,與其他8因子均無相關(guān)性。 研究結(jié)論 1.不同性別白癜風患者在發(fā)病部位以及皮損的單雙側(cè)分布等方面無明顯差異;與正常成人常模比較,白癜風患者心理健康狀況整體較差;與穩(wěn)定期的患者相比,活動期患者負性情緒更多,在強迫癥狀、人際關(guān)系敏感、抑郁、焦慮、敵對、恐怖、偏執(zhí)、精神病性等癥狀方面更明顯;白癜風患者心理健康狀況與病情的發(fā)展及皮損面積相關(guān)。 2.白癜風患者不論男性、女性,P量表(精神質(zhì))、E量表(內(nèi)-外向)、N量表(神經(jīng)質(zhì))及在L因素(懷疑性)、M因素(幻想性)的分值都高于常模組,而在C因素(穩(wěn)定性)、G因素(有恒性)等方面均低于常模組,在人格結(jié)構(gòu)中,表現(xiàn)為易焦慮、緊張、擔憂、郁郁不樂、憂心忡忡;情緒起伏較大,渴望刺激和冒險;對人抱有敵意,難以適應(yīng)外部環(huán)境,與他人不能友好相處;固執(zhí)、倔強、喜歡尋釁、缺乏同情心等人格特征。 3.穩(wěn)定性差、缺乏自信、憂慮性高、緊張性高及懷疑性高的患者在強迫癥狀、人際關(guān)系敏感、抑郁、焦慮、恐怖、軀體化、敵對、精神病性等方面的負性情緒明顯。而樂群性、智慧性、影響性、有恒性、情感性、幻想性、世故性、變革性等因子與SCL-90各因子均無相關(guān)性,說明白癜風患者無論以上各人格特征有無差異,其出現(xiàn)各種心理癥狀的機會均等。
[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.
【學位授予單位】：第四軍醫(yī)大學
【學位級別】：碩士
【學位授予年份】：2007
【分類號】：R758.41;R395

【引證文獻】

相關(guān)期刊論文 前1條

1 程亞南;苗青;張江安;賈名妍;;白癜風287例臨床分析[J];中國皮膚性病學雜志;2012年09期

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本文編號：2102737