Nijenhuis E R, van Dyck R, Spinhoven P, van der Hart O, Chatrou M, Vanderlinden J, Moene F
Vrije Universiteit at Amsterdam, The Netherlands.
Aust N Z J Psychiatry. 1999 Aug;33(4):511-20. doi: 10.1080/j.1440-1614.1999.00601.x.
The primary aim of this study was to investigate the hypothesis that somatoform dissociation would differentiate among specific diagnostic categories after controlling for general psychopathology.
The Somatoform Dissociation Questionnaire (SDQ-20), the Dissociative Experiences Scale, and the Symptom Checklist-90-R were completed by patients with DSM-IV diagnoses of dissociative disorders (n = 44), somatoform disorders (n = 47), eating disorders (n = 50), bipolar mood disorder (n = 23), and a group of consecutive psychiatric outpatients with other psychiatric disorders (n = 45), mainly including anxiety disorders, depression, and adjustment disorder.
The SDQ-20 significantly differentiated among diagnostic groups in the hypothesised order of increasing somatoform dissociation, both before and after statistically controlling for general psychopathology. Somatoform dissociation was extreme in dissociative identity disorder, high in dissociative disorder, not otherwise specified, and increased in somatoform disorders, as well as in a subgroup of patients with eating disorders. In contrast with somatoform dissociation, psychological dissociation did not discriminate between bipolar mood disorder and somatoform disorders.
Somatoform dissociation is a unique construct that discriminates among diagnostic categories. It is highly characteristic of dissociative disorder patients, a core feature in many patients with somatoform disorders, and an important symptom cluster in a subgroup of patients with eating disorders.
本研究的主要目的是检验这样一个假设,即在控制了一般精神病理学因素之后,躯体形式解离在特定诊断类别之间存在差异。
解离障碍(n = 44)、躯体形式障碍(n = 47)、进食障碍(n = 50)、双相情感障碍(n = 23)患者以及一组患有其他精神障碍(主要包括焦虑症、抑郁症和适应障碍,n = 45)的连续精神科门诊患者完成了躯体形式解离问卷(SDQ - 20)、解离体验量表和症状自评量表 - 90修订版。
在对一般精神病理学因素进行统计控制之前和之后,SDQ - 20均按照躯体形式解离增加的假设顺序在诊断组之间显示出显著差异。躯体形式解离在分离性身份障碍中最为极端,在未另行说明的解离障碍中较高,在躯体形式障碍以及进食障碍患者亚组中也有所增加。与躯体形式解离不同,心理解离在双相情感障碍和躯体形式障碍之间没有区分作用。
躯体形式解离是一种独特的结构,可在诊断类别之间进行区分。它是解离障碍患者的高度特征性表现,是许多躯体形式障碍患者的核心特征,也是进食障碍患者亚组中的一个重要症状群。