van Fenema Esther, Julsing Jolien E, Carlier Ingrid V, van Noorden Martijn S, Giltay Erik J, van Wee Nic J, Zitman Frans G
Dept. of Psychiatry B1-P, Leiden University Medical Center, Leiden, The Netherlands.
Med Probl Perform Art. 2013 Mar;28(1):9-18.
Musicians are at increased risk for mental disorders, in particular performance anxiety. Likely causes are high levels of occupational stress, special personality traits, and coping skills. In this cross-sectional study, routine outcome monitoring (ROM) data on clinical and psychosocial characteristics were collected from the first 50 musicians visiting our outpatient psychiatric clinic for performing artists and were compared to those of a large sample of psychiatric outpatients (n=1,498) and subjects from the general population. Of the musician outpatients, 82% (n=41) met the criteria of an Axis I psychiatric disorder. Performance anxiety could not be accurately diagnosed with the MINI-plus, and in a few cases it masked different psychiatric disorders. Musician outpatients scored significantly better on functional scales despite their Axis I disorder, with equal scores on scales measuring distress compared to general outpatients. Musicians displayed significantly higher mean scores on the DAPP-sf subscale measuring narcissistic personality traits than general outpatients and non-patient controls (p=0.001). Diagnostic challenges, in particular regarding performance anxiety, of musicians seeking psychiatric care are thoroughly discussed. Musicians with psychiatric disorders may constitute a group of patients with specific characteristics who may benefit from specialized psychiatric care, and health professionals should be aware of the high prevalence of psychiatric disorders in musicians.
音乐家患精神障碍的风险增加，尤其是表演焦虑症。可能的原因是高水平的职业压力、特殊的人格特质和应对技巧。在这项横断面研究中，我们收集了前50名到我们的表演艺术家门诊精神科就诊的音乐家的临床和社会心理特征的常规结果监测（ROM）数据，并与大量精神科门诊患者样本（n = 1498）和普通人群的受试者数据进行了比较。在音乐家门诊患者中，82%（n = 41）符合轴I精神障碍的标准。使用MINI-plus无法准确诊断表演焦虑症，在少数情况下，它掩盖了不同的精神障碍。尽管患有轴I障碍，但音乐家门诊患者在功能量表上的得分明显更高，在测量痛苦程度的量表上与普通门诊患者得分相同。在测量自恋人格特质的DAPP-sf子量表上，音乐家的平均得分显著高于普通门诊患者和非患者对照组（p = 0.001）。本文深入讨论了寻求精神科护理的音乐家所面临的诊断挑战，尤其是与表演焦虑症相关的挑战。患有精神障碍的音乐家可能构成一组具有特定特征的患者群体，他们可能受益于专门的精神科护理，卫生专业人员应意识到音乐家群体中精神障碍的高患病率。
