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心肌梗死后不同创伤后应激障碍水平患者的共病情况及人格特质

Comorbidity and personality traits in patients with different levels of posttraumatic stress disorder following myocardial infarction.

作者信息

Chung Man Cheung, Berger Zoë, Rudd Hannah

机构信息

University of Plymouth, Clinical Psychology Teaching Unit, Peninsula Allied Health Centre, College of St Mark & St John, Derriford Road, Plymouth, PL6 8BH, UK.

出版信息

Psychiatry Res. 2007 Aug 30;152(2-3):243-52. doi: 10.1016/j.psychres.2007.02.008. Epub 2007 Jul 2.

Abstract

More research is needed to further our understanding of posttraumatic stress responses and comorbidity following myocardial infarction (MI), and to help us identify more clearly the personality traits which indicate that a person is more prone to developing post-MI posttraumatic stress disorder (PTSD). This study aimed to 1) investigate the comorbidity of patients who suffered from different levels of posttraumatic stress disorder following myocardial infarction (i.e. post-MI PTSD), and 2) investigate to what extent patients with different levels of post-MI PTSD differed in their personality traits. One hundred and twenty MI patients from two general practices were recruited for the study. They were asked to complete the Posttraumatic Stress Diagnostic Scale (PDS), the General Health Questionnaire-28 (GHQ-28) and the NEO-Five Factor Inventory (NEO-FFI). They were divided into a no-PTSD group, a partial-PTSD group and a full-PTSD group, according to the scores of the PDS. One hundred and sixteen members of the general public were also recruited for comparison purposes. They were asked to complete the GHQ-28. The results showed that patients with full-PTSD reported significantly more somatic problems, anxiety, social dysfunction and depression than the other two patient groups and the control group. When age, bypass surgery, mental health problems before MI and angioplasty were controlled for, patients with full-PTSD also reported greater symptom severity of the four GHQ subscales than the other two patient groups. Patients with full-PTSD were significantly more neurotic than those with no-PTSD and partial-PTSD. Patients with full-PTSD were less agreeable than patients with no-PTSD. Regression analyses showed that personality did not moderate the relationship between PTSD and comorbidity. To conclude, following MI, those with full-PTSD tend to report more severe comorbidity than those who have not developed PTSD fully. The former can also be distinguished from the latter by virtue of their specific personality traits.

摘要

需要进行更多研究,以加深我们对心肌梗死(MI)后创伤后应激反应及共病情况的理解,并帮助我们更清晰地识别出表明某人更易患心肌梗死后创伤后应激障碍(PTSD)的人格特质。本研究旨在:1)调查心肌梗死后患有不同程度创伤后应激障碍(即心肌梗死后PTSD)患者的共病情况;2)调查不同程度心肌梗死后PTSD患者在人格特质上的差异程度。从两家普通诊所招募了120名心肌梗死患者参与该研究。他们被要求完成创伤后应激诊断量表(PDS)、一般健康问卷-28(GHQ-28)和大五人格问卷(NEO-FFI)。根据PDS得分,他们被分为无PTSD组、部分PTSD组和完全PTSD组。还招募了116名普通公众用于比较。他们被要求完成GHQ-28。结果显示,完全PTSD患者报告的躯体问题、焦虑、社会功能障碍和抑郁明显多于其他两组患者及对照组。在控制了年龄、搭桥手术、心肌梗死前的心理健康问题和血管成形术后,完全PTSD患者在GHQ四个分量表上的症状严重程度也高于其他两组患者。完全PTSD患者比无PTSD和部分PTSD患者明显更神经质。完全PTSD患者比无PTSD患者更不随和。回归分析表明,人格并未调节PTSD与共病之间的关系。总之,心肌梗死后,完全PTSD患者往往比未完全患PTSD的患者报告更严重的共病情况。前者也可凭借其特定的人格特质与后者区分开来。

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