Ketterer M W, Fitzgerald F, Thayer B, Moraga R, Mahr G, Keteyian S J, McGowan C, Stein P, Goldberg A D
Heart and Vascular Institute, Henry Ford Health Sciences Center, Detroit, USA.
J Cardiovasc Risk. 2000 Dec;7(6):409-13. doi: 10.1177/204748730000700603.
Psychosocial/emotional distress has been repeatedly found to be a correlate of the onset/aggravation of ischaemic heart disease.
Eighty-three patients (63 men and 20 women) with known coronary artery disease who entered an aggressive lifestyle modification programme were administered a clinical/demographic history and the Symptom Checklist 90--Revised at baseline. Several measures of social isolation/alienation (shyness/self-consciousness, feeling lonely, feeling abused and overall) were derived from the the Symptom Checklist 90--Revised.
Univariate tests of the association of known cardiovascular risk factors and the Symptom Checklist 90--Revised scales with age at initial diagnosis yielded several significant results for history of hypercholesterolaemia (P = 0.018), history of hypertension (P = 0.030), somatization (P = 0.007), obsessive-compulsive (P = 0.009), depression (P = 0.006), anxiety (P = 0.021), hostility (P = 0.003), paranoia (P = 0.050), psychoticism (P = 0.029), the Global Severity Index (P = 0.007), the Positive Symptom Distress Index (P = 0.005), the Positive Symptom Total Score (P = 0.003) and feeling abused (P = 0.037). Only history of hypertension, history of hypercholesterolaemia and the hostility scale (overall F = 6.08 and P = 0.0009) emerged as unique correlates of age at initial diagnosis in a multiple regression using only the significant univariate predictors.
Psychosocial factors are sufficiently confounded with one another that they lose their predictive value once one is entered in the equation. High scores on the hostility scale were associated with a 5.7 year differential in age at initial diagnosis. The younger a patient is at initial diagnosis, the more likely he/she is to have high levels of emotional distress.
社会心理/情绪困扰反复被发现是缺血性心脏病发病/加重的一个相关因素。
83例已知患有冠状动脉疾病并参加积极生活方式改善计划的患者（63名男性和20名女性）在基线时接受了临床/人口统计学病史调查以及症状自评量表90修订版测试。从症状自评量表90修订版中得出了几种社会隔离/疏离感的测量指标（害羞/自觉、感到孤独、感到受虐以及总体情况）。
对已知心血管危险因素和症状自评量表90修订版各分量表与初次诊断年龄之间的关联进行单变量检验，得出了以下几个显著结果：高胆固醇血症病史（P = 0.018）、高血压病史（P = 0.030）、躯体化（P = 0.007）、强迫观念与行为（P = 0.009）、抑郁（P = 0.006）、焦虑（P = 0.021）、敌对（P = 0.003）、偏执（P = 0.050）、精神质（P = 0.029）、总体严重程度指数（P = 0.007）、阳性症状苦恼指数（P = 0.005）、阳性症状总分（P = 0.003）以及感到受虐（P = 0.037）。在仅使用显著单变量预测因素进行的多元回归分析中，只有高血压病史、高胆固醇血症病史和敌对分量表（总体F = 6.08，P = 0.0009）成为初次诊断年龄的独特相关因素。
社会心理因素之间相互混杂程度很高，以至于一旦将其中一个因素纳入方程，它们就会失去预测价值。敌对分量表得分高与初次诊断年龄相差5.7岁有关。患者初次诊断时年龄越小，其情绪困扰水平越高的可能性就越大。
