Bayle O, Consoli S M, Baudin M, Vayssairat M, Fiessinger J N, Housset E
Unité Médico-Psychologique, Hôpital Broussais, Paris.
Presse Med. 1990 Apr 21;19(16):741-5.
Thirty subjects with Raynaud's phenomenon admitted for determination of its cause underwent psychological examination. Raynaud's phenomenon was regarded as primary in 14 cases, secondary (usually to scleroderma) in 13 cases and eluding classification in 3 cases. The mean age of patients with primary Raynaud's phenomenon was higher than in the other groups. Interviews and psychological tests were carried out with all but 2 patients and all investigators being totally unaware of the aetiological category. Patients with secondary Raynaud's phenomenon significantly differed from those with primary Raynaud's phenomenon in their personality patterns, attitudes towards interlocutors and way of coping with conflicts. Patients with primary Raynaud's phenomenon were characterized by a relatively frequent hysterical personality and by their dodging behaviour when faced with their own aggressiveness. Patients with secondary Raynaud's phenomenon were found to be more distant, more conformist, more able to control their emotions and seemed to be less inclined to seek help when in trouble. Such findings suggest that Raynaud's phenomenon has a "psychosomatic" component: a psychic vulnerability which might contribute to the progress of the disease, and more clearly so in patients with secondary Raynaud's phenomenon than in patients with primary Raynaud's phenomenon, as confirmed by the so-called psychic fragility" score used to quantify the efficiency of mental functioning. These psychological features were unrelated to age. The profile of patients with secondary Raynaud's phenomenon is close to pattern C described as possibly having a prognostic value in proliferative or autoimmune diseases.
30名因雷诺现象入院以确定病因的患者接受了心理检查。14例雷诺现象被视为原发性，13例为继发性（通常继发于硬皮病），3例难以分类。原发性雷诺现象患者的平均年龄高于其他组。除2名患者外，对所有患者都进行了访谈和心理测试，所有调查人员完全不知道病因类别。继发性雷诺现象患者在性格模式、对对话者的态度和应对冲突的方式上与原发性雷诺现象患者有显著差异。原发性雷诺现象患者的特点是癔症性格相对常见，面对自身攻击性时表现出逃避行为。继发性雷诺现象患者则表现得更为冷漠、更墨守成规、更能控制自己的情绪，遇到麻烦时似乎不太倾向于寻求帮助。这些发现表明，雷诺现象有一个“心身”成分：一种心理易损性，它可能促进疾病的进展，继发性雷诺现象患者比原发性雷诺现象患者更明显，这一点通过用于量化心理功能效率的所谓“心理脆弱性”评分得到了证实。这些心理特征与年龄无关。继发性雷诺现象患者的特征与模式C相似，模式C被认为可能对增殖性或自身免疫性疾病具有预后价值。
