Valkamo M, Hintikka J, Honkalampi K, Niskanen L, Koivumaa-Honkanen H, Viinamäki H
Department of Psychiatry, Kuopio University Hospital, P.O. Box 1777, FI-70211 Kuopio, Finland.
J Psychosom Res. 2001 Mar;50(3):125-30. doi: 10.1016/s0022-3999(00)00209-9.
The aim of this study was to investigate factors associated with alexithymia in patients (n=153) with coronary heart disease (CHD) verified by coronary angiography.
Self-rated depression was assessed using 21-item Beck Depression Inventory (BDI) and other psychiatric symptoms with Symptom Check List-90 (SCL-90). Life satisfaction was assessed using a separate scale. The Structured Clinical Interview (SCID I and II) for DSM-III-R was used to identify mental disorders. Assessments took place 1 day before angiography.
Twenty-one percent of CHD patients (n=32) were assessed as being alexithymic according to the Toronto Alexithymia Scale (TAS-20). Alexithymics were more often blue-collar workers, incapable of working, dissatisfied with life, and depressed than the other CHD patients. Occurrences of mental disorders were not associated with alexithymia. Logistic regression analysis revealed that factors independently associated with alexithymia were currently or previously being a blue-collar worker (adjusted odds ratio, AOR: 4.8), self-rated depression (AOR: 3.2), and dissatisfaction with life (AOR: 2.9).
In CHD patients alexithymia was unrelated to cardiovascular risk factors or exercise capacity but was related to self-rated depression and decreased life satisfaction. Alexithymia is associated with the enhanced psychosocial burden of suffering CHD. This patient group may need more individual support and attention than other CHD patients.
本研究旨在调查经冠状动脉造影证实的冠心病（CHD）患者（n = 153）中与述情障碍相关的因素。
使用21项贝克抑郁量表（BDI）评估自评抑郁状况，用症状自评量表90（SCL - 90）评估其他精神症状。使用单独的量表评估生活满意度。采用针对《精神疾病诊断与统计手册》第三版修订版（DSM - III - R）的结构化临床访谈（SCID I和II）来识别精神障碍。评估在血管造影前1天进行。
根据多伦多述情障碍量表（TAS - 20），21%的冠心病患者（n = 32）被评估为有述情障碍。与其他冠心病患者相比，有述情障碍的患者更多是蓝领工人，无法工作，对生活不满且抑郁。精神障碍的发生与述情障碍无关。逻辑回归分析显示，与述情障碍独立相关的因素包括目前或既往为蓝领工人（调整优势比，AOR：4.8）、自评抑郁（AOR：3.2）以及对生活不满（AOR：2.9）。
在冠心病患者中，述情障碍与心血管危险因素或运动能力无关，但与自评抑郁及生活满意度降低有关。述情障碍与患冠心病所带来的心理社会负担加重相关。相较于其他冠心病患者，这一患者群体可能需要更多的个人支持和关注。
