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区分慢性疲劳综合征与抑郁症:一项认知分析。

Discriminating between chronic fatigue syndrome and depression: a cognitive analysis.

作者信息

Moss-Morris R, Petrie K J

机构信息

Health Psychology Research Group, Faculty of Medical and Health Science, The University of Auckland, New Zealand.

出版信息

Psychol Med. 2001 Apr;31(3):469-79. doi: 10.1017/s0033291701003610.

Abstract

BACKGROUND

Chronic fatigue syndrome (CFS) and depression share a number of common symptoms and the majority of CFS patients meet lifetime criteria for depression. While cognitive factors seem key to the maintenance of CFS and depression, little is known about how the cognitive characteristics differ in the two conditions.

METHODS

Fifty-three CFS patients were compared with 20 depressed patients and 38 healthy controls on perceptions of their health, illness attributions, self-esteem, cognitive distortions of general and somatic events, symptoms of distress and coping. A 6 month follow-up was also conducted to determine the stability of these factors and to investigate whether CFS-related cognitions predict ongoing disability and fatigue in this disorder.

RESULTS

Between-group analyses confirmed that the depressed group was distinguished by low self-esteem, the propensity to make cognitive distortions across all situations, and to attribute their illness to psychological factors. In contrast, the CFS patients were characterized by low ratings of their current health status, a strong illness identity, external attributions for their illness, and distortions in thinking that were specific to somatic experiences. They were also more likely than depressed patients to cope with their illness by limiting stress and activity levels. These CFS-related cognitions and behaviours were associated with disability and fatigue 6 months later.

CONCLUSIONS

CFS and depression can be distinguished by unique cognitive styles characteristic of each condition. The documented cognitive profile of the CFS patients provides support for the current cognitive behavioural models of the illness.

摘要

背景

慢性疲劳综合征(CFS)与抑郁症有许多共同症状,大多数CFS患者符合抑郁症的终生诊断标准。虽然认知因素似乎是维持CFS和抑郁症的关键,但对于这两种疾病的认知特征如何不同却知之甚少。

方法

将53名CFS患者与20名抑郁症患者及38名健康对照者在健康认知、疾病归因、自尊、对一般事件和躯体事件的认知歪曲、痛苦症状及应对方式等方面进行比较。还进行了为期6个月的随访,以确定这些因素的稳定性,并调查与CFS相关的认知是否能预测该疾病中持续存在的残疾和疲劳。

结果

组间分析证实,抑郁症组的特点是自尊水平低、在所有情况下都有认知歪曲的倾向,并将其疾病归因于心理因素。相比之下,CFS患者的特点是对当前健康状况评价低、强烈的疾病认同感、对其疾病的外部归因,以及特定于躯体体验的思维歪曲。他们也比抑郁症患者更倾向于通过限制压力和活动水平来应对疾病。这些与CFS相关的认知和行为在6个月后与残疾和疲劳相关。

结论

CFS和抑郁症可通过每种疾病特有的认知方式加以区分。记录的CFS患者的认知概况为当前该疾病的认知行为模型提供了支持。

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