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[慢性盆腔疼痛综合征与人格——躯体症状与心理结构的关联]

[Chronic Pelvic Pain Syndrome and Personality--Association of Somatic Symptoms and Psychic Structure].

作者信息

Albrecht Rebecca, Löwe Bernd, A Brünahl Christian, Riegel Björn

机构信息

Institut und Poliklinik für Psychosomatische Medizin und Psychotherapie, Psychsomatische Medizin und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf & Schön Klinik Hamburg Eilbek.

出版信息

Psychother Psychosom Med Psychol. 2015 Nov;65(11):418-25. doi: 10.1055/s-0035-1554692. Epub 2015 Jul 22.

Abstract

BACKGROUND

Despite its high prevalence, little is known about the aetiology and maintenance of Chronic Pelvic Pain Syndrome (CPPS). CPPS is is considered to be a multi-causal syndrome with discomfort and pain in the pelvis. Recent literature suggests that psychosocial factors are important for understanding CPPS. For example, CPPS has been associated with deficits in mentalization and bonding experiences. Our study aims to characterize features of personality disorders according to DSM-IV and psychic structure according to OPD-2 in CPPS patients. Furthermore, we examine the association of personality aspects with urological symptoms (NIH Questionnaire) and pain perception (MPQ Questionnaire).

MATERIALS & METHODS: Personality aspects were assessed in a total of 109 patients from our CPPS outpatient clinic using standardized questionnaires. To characterize CPPS patients, we compared the sample's scores with reference groups, mostly the general population. In addition, the associations between personality aspects and both the urologic symptoms and pain perception were assessed using correlations. Missing data were replaced using multiple imputation methods.

RESULTS

Compared to reference values, we found 'experiencing emotions' and 'creating relationships' as specific deficits in CPPS patients. Furthermore, patients' self-image (more dominant, higher depressive mood) differs from the general population. A higher pain perception was correlated with deficits in most personality aspects we measured. However, this was not the case for the severity of urological symptoms.

DISCUSSION & CONCLUSION: Compared to the reference values, only a few personality aspects differed in CPPS patients but there was a correlational association between different personality traits and pain perception. Despite the extend of symptoms, pain perception is associated with difficulty (emotional ability) in dealing with emotions, self-management and relationships. These personality aspects should be taken into account when planning therapy.

摘要

背景

尽管慢性盆腔疼痛综合征(CPPS)患病率很高,但对其病因及维持因素知之甚少。CPPS被认为是一种多病因综合征,伴有骨盆不适和疼痛。最近的文献表明,心理社会因素对于理解CPPS很重要。例如,CPPS与心理化和依恋经历缺陷有关。我们的研究旨在根据《精神疾病诊断与统计手册第四版》(DSM-IV)对CPPS患者的人格障碍特征进行描述,并根据《操作性心理动力学诊断手册第二版》(OPD-2)对其心理结构进行描述。此外,我们还研究人格方面与泌尿症状(美国国立卫生研究院问卷)和疼痛感知(麦吉尔疼痛问卷)之间的关联。

材料与方法

我们使用标准化问卷对CPPS门诊诊所的109例患者的人格方面进行了评估。为了描述CPPS患者的特征,我们将样本得分与参考组(主要是普通人群)进行了比较。此外,使用相关性分析评估了人格方面与泌尿症状和疼痛感知之间的关联。缺失数据使用多重填补法进行替换。

结果

与参考值相比,我们发现“情绪体验”和“建立关系”是CPPS患者的特定缺陷。此外,患者的自我形象(更具支配性、更高的抑郁情绪)与普通人群不同。更高的疼痛感知与我们测量的大多数人格方面的缺陷相关。然而,泌尿症状的严重程度并非如此。

讨论与结论

与参考值相比,CPPS患者只有少数人格方面存在差异,但不同人格特质与疼痛感知之间存在相关性。尽管症状范围广泛,但疼痛感知与处理情绪、自我管理和人际关系方面的困难(情绪能力)有关。在规划治疗时应考虑这些人格方面。

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