原发性醛固酮增多症的心理评估：一项对照研究。
Psychological assessment of primary aldosteronism: a controlled study.
机构信息
Department of Statistical Sciences, University of Padova, 35128 Padova, Italy.
出版信息
J Clin Endocrinol Metab. 2011 Jun;96(6):E878-83. doi: 10.1210/jc.2010-2723. Epub 2011 Mar 9.
OBJECTIVE
Our objective was to investigate psychological correlates in a population with primary aldosteronism (PA) using methods found to be sensitive and reliable in psychosomatic research.
METHODS
Twenty-three PA patients (12 male, 11 female; mean age 50 ± 9 yr) were compared with 23 patients with essential hypertension (EH) (15 male, eight female; mean age 47 ± 8 yr) and 23 matched normotensive subjects. A modified version of the Structural Clinical Interview for DSM-IV, a shortened version of the structured interview for the Diagnostic Criteria for Psychosomatic Research, and two self-rating questionnaires, the Psychosocial Index and the Symptom Questionnaire, were administered.
RESULTS
Twelve of 23 patients with PA (52.2%) suffered from an anxiety disorder compared with four of 23 with EH (17.4%) and one control (4.3%) (P < 0.001). Generalized anxiety disorder was more frequent in PA than in EH patients and controls (P < 0.05). As assessed by Diagnostic Criteria for Psychosomatic Research, irritable mood was more frequent in PA and EH compared with controls (P < 0.05) but did not differentiate PA from EH. According to Psychosocial Index results, patients with PA had higher levels of stress (P < 0.01) and psychological distress (P < 0.01) and lower level of well-being (P < 0.05) than controls. Compared with EH patients, PA patients had higher scores in stress subscale (P < 0.05). The Symptom Questionnaire showed higher levels of anxiety (P < 0.01), depression (P < 0.01) and somatization (P < 0.01) and lower physical well-being (P < 0.05) in PA than controls.
CONCLUSION
A role of mineralocorticoid regulatory mechanisms in clinical situations concerned with anxiety and stress is suggested.
目的
本研究旨在采用在身心医学研究中被证实灵敏可靠的方法，探究原发性醛固酮增多症（PA）患者的心理相关因素。
方法
23 名 PA 患者（12 名男性，11 名女性；平均年龄 50 ± 9 岁）与 23 名原发性高血压（EH）患者（15 名男性，8 名女性；平均年龄 47 ± 8 岁）和 23 名匹配的血压正常受试者进行比较。使用 DSM-IV 结构临床访谈的改良版、身心研究诊断标准的简短版结构化访谈以及两个自我评估问卷，即心理社会指数和症状问卷进行评估。
结果
23 名 PA 患者中有 12 名（52.2%）患有焦虑障碍，而 23 名 EH 患者中有 4 名（17.4%）和 1 名对照者（4.3%）患有焦虑障碍（P < 0.001）。PA 患者的广泛性焦虑障碍比 EH 患者和对照组更常见（P < 0.05）。根据身心研究诊断标准评估，PA 和 EH 患者的易怒情绪比对照组更常见（P < 0.05），但不能区分 PA 和 EH。根据心理社会指数结果，PA 患者的压力水平较高（P < 0.01），心理困扰程度较高（P < 0.01），幸福感较低（P < 0.05），与对照组相比。与 EH 患者相比，PA 患者的压力子量表得分更高（P < 0.05）。症状问卷显示，PA 患者的焦虑水平较高（P < 0.01），抑郁水平较高（P < 0.01），躯体化程度较高（P < 0.01），身体幸福感较低（P < 0.05），与对照组相比。
结论
提示盐皮质激素调节机制在与焦虑和压力相关的临床情况下发挥作用。
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