Ketterer M W, Denollet J, Chapp J, Thayer B, Keteyian S, Clark V, John S, Farha A J, Deveshwar S
Department of Psychology, Tilburg University, The Netherlands.
J Psychosom Res. 2004 Jan;56(1):119-23. doi: 10.1016/S0022-3999(03)00501-4.
In this study patients with documented ischemic coronary heart disease (ICHD; prior MI or CAD per catheterization) were tested for the association of various measures of emotional distress with Age at Initial Diagnosis.
The measures were chosen because of a published track record at predicting mortality in this population. Females were oversampled to achieve equivalent numbers of each sex (n=50), and thus equivalent statistical power. In a subset of patients (38 males and 32 females), Spouse/Friend Ketterer Stress Symptom Frequency Checklists (KSSFCs) were received.
Females reported more depression and anxiety than males. However, spouses or friends reported more anger for males. Denial (spouse/friend minus self-ratings) was greater in males for all three scales of the KSSFC (Anger, P=.005; Depression, P=.024; Anxiety, P=.001). Although females showed the same trend, self and spouse or friend ratings of distress were significantly associated with Age at Initial Diagnosis only in males. When split at the sample mean on the Spouse/Friend KSSFC AIAI (Anger) scale, Age at Initial Diagnosis occurred 14.2 years earlier in males.
Use of a significant other in assessing psychosocial/emotional distress in males may confer greater accuracy, and therefore predictive power for clinical endpoints.
在本研究中，对有记录的缺血性冠心病（ICHD；根据导管插入术确定为既往心肌梗死或冠心病）患者进行测试，以探究各种情绪困扰指标与初次诊断年龄之间的关联。
选择这些指标是因为它们在预测该人群死亡率方面有已发表的记录。女性被过度抽样以实现男女数量相等（n = 50），从而获得同等的统计效力。在一部分患者（38名男性和32名女性）中，收集了配偶/朋友的凯特勒应激症状频率检查表（KSSFC）。
女性报告的抑郁和焦虑比男性更多。然而，配偶或朋友报告男性的愤怒情绪更多。在KSSFC的所有三个量表（愤怒、抑郁、焦虑）中，男性的否认（配偶/朋友评分减去自我评分）程度更高（愤怒，P = .005；抑郁，P = .024；焦虑，P = .001）。虽然女性也呈现相同趋势，但只有男性的自我以及配偶或朋友的困扰评分与初次诊断年龄显著相关。当根据配偶/朋友KSSFC的AIAI（愤怒）量表的样本均值进行划分时，男性的初次诊断年龄要早14.2年。
在评估男性的心理社会/情绪困扰时使用重要他人可能会提高准确性，从而增强对临床终点的预测能力。
