Gupta Madhulika A, Gupta Aditya K
Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.
J Psychosom Res. 2006 Feb;60(2):131-6. doi: 10.1016/j.jpsychores.2005.06.061.
We examined the relation between medically unexplained cutaneous symptoms and dissociation [measured by the Dissociative Experiences Scale, or DES; Bernstein EM, Putnam FW. Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis 1986;174:727-35] among participants with no history of primary dermatologic disorders.
Three hundred sixty consenting participants (44 psychiatric outpatients and 316 nonclinical participants from the community at large) rated the severity of nine medically unexplained cutaneous symptoms (sum of all ratings comprised the Cutaneous9 variable) and completed the DES.
The Cutaneous9 variable correlated significantly (Pearson r=.56, P<.001) with DES scores. Stepwise multiple regression analysis using the nine cutaneous symptoms as independent variables revealed that Pain, Itching, and Numbness were the best predictors of the DES scores (adjusted R2=.34, P<.001).
Our findings have empirically shown that itching, like pain and numbness, may be a symptom of somatoform dissociation. Second, even milder degrees of dissociation in the nonclinical range may play a role in the genesis of unexplained cutaneous sensory symptoms.
我们在无原发性皮肤病病史的参与者中,研究了医学上无法解释的皮肤症状与分离[通过分离体验量表(DES)测量;伯恩斯坦EM,普特南FW。分离量表的编制、信度和效度。《神经精神疾病杂志》1986年;174:727 - 35]之间的关系。
360名同意参与的参与者(44名精神科门诊患者和316名来自广大社区的非临床参与者)对9种医学上无法解释的皮肤症状的严重程度进行评分(所有评分之和构成皮肤9变量),并完成DES量表。
皮肤9变量与DES评分显著相关(皮尔逊r = 0.56,P <.001)。以9种皮肤症状作为自变量进行逐步多元回归分析显示,疼痛、瘙痒和麻木是DES评分的最佳预测因素(调整后R2 = 0.34,P <.001)。
我们的研究结果通过实证表明,与疼痛和麻木一样,瘙痒可能是躯体形式分离的一种症状。其次,即使是非临床范围内较轻程度的分离也可能在不明原因的皮肤感觉症状的发生中起作用。