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冠状动脉或瓣膜性心脏病患者的气质和性格特征及精神共病:与心脏病严重程度的关系

Temperament and Character Profiles and Psychiatric Comorbidities in Patients With Coronary Artery or Valvular Heart Disease: Relationship With Cardiac Disease Severity.

作者信息

Bezgin Cigdem Hazal, Bezgin Tahir, Kesebir Sermin

机构信息

Department of Psychiatry, Erenkoy Psychiatry Training and Research Hospital, Goztepe, Istanbul, Turkey.

Department of Cardiology, Kartal Kosuyolu Heart Research Hospital, Kartal, Istanbul, Turkey.

出版信息

J Clin Med Res. 2016 Mar;8(3):202-9. doi: 10.14740/jocmr2440w. Epub 2016 Jan 26.

Abstract

BACKGROUND

We aimed to investigate whether the psychopathological symptoms and temperament-character dimensions observed in patients operated due to coronary artery disease (CAD) or valvular heart disease (VHD) differ among the patients and from healthy individuals.

METHODS

Study population was composed of subjects with CAD, VHD and healthy controls (n = 50 in each group). Socio-demographic questionnaire, temperament and character inventory (TCI) and symptom check list-90-R (SCL-90-R) were applied to all groups. Groups were compared about temperament-character dimensions and scores of subscales of SCL-90-R.

RESULTS

Harm avoidance was found to be higher in VHD group than those with CAD and, lower in healthy controls than both patient groups (P = 0.004). Reward dependence was similar among both patient groups and, was higher than healthy group (P = 0.015). Depression, anxiety, somatization, obsession and interpersonal sensitivity were found to be similar in both patient groups but they were higher than those in controls (P < 0.001, P < 0.001, P < 0.001, P = 0.002 and P = 0.003, respectively). Phobia was seen equally in CAD group and healthy controls and, was found to be lower in these than in VHD (P = 0.009). Anger score was in descending order in patients with VHD, CAD and healthy controls group (P = 0.010 and 0.001). Paranoia was in descending order in patients with VHD, CAD and controls (P = 0.015 and 0.001). A weak and inverse correlation was found between ejection fraction (EF) and the persistence dimension of temperament scaled by TCI in patients with VHD (r = -0.276, P = 0.052). An inverse correlation was observed between EF and the reward dependence dimension in CAD group (r = -0.195, P = 0.044). In patients with VHD, EF demonstrated an inversely weak (r = -0.289, P = 0.042), moderate (r = -0.360, P = 0.010) and strong (r = -0.649, P < 0.001) correlation with inter-personal sensitivity, phobia and paranoia, respectively. There was an inverse and weak correlation between EF and depression and anger in VHD group (r = -0.302, P = 0.033 and r = -0.240, P = 0.054).

CONCLUSION

VHD and CAD exhibit different psychopathological symptoms and temperament traits. There is a correlation between the aforementioned psychopathological symptoms and temperament traits, and EF.

摘要

背景

我们旨在研究因冠状动脉疾病(CAD)或心脏瓣膜病(VHD)接受手术的患者所观察到的心理病理症状和气质性格维度在患者之间以及与健康个体之间是否存在差异。

方法

研究人群由CAD患者、VHD患者和健康对照者组成(每组n = 50)。对所有组均应用社会人口学问卷、气质性格量表(TCI)和症状自评量表90修订版(SCL - 90 - R)。比较各组的气质性格维度和SCL - 90 - R各子量表得分。

结果

发现VHD组的回避伤害得分高于CAD组患者,且健康对照组低于两个患者组(P = 0.004)。两个患者组之间的奖赏依赖相似,且高于健康组(P = 0.015)。发现两个患者组的抑郁、焦虑、躯体化、强迫观念和人际敏感得分相似,但高于对照组(分别为P < 0.001、P < 0.001、P < 0.001、P = 0.002和P = 0.003)。恐惧症在CAD组和健康对照组中出现频率相同,且发现这两组中的恐惧症得分低于VHD组(P = 0.009)。愤怒得分在VHD患者、CAD患者和健康对照组中呈递减顺序(P = 0.010和0.001)。偏执狂在VHD患者、CAD患者和对照组中呈递减顺序(P = 0.015和0.001)。在VHD患者中,射血分数(EF)与TCI所衡量的气质坚持性维度之间存在微弱的负相关(r = -0.276,P = 0.052)。在CAD组中,观察到EF与奖赏依赖维度之间存在负相关(r = -0.195,P = 0.044)。在VHD患者中,EF与人际敏感、恐惧症和偏执狂分别呈微弱负相关(r = -0.289,P = 0.042)、中度负相关(r = -0.360,P = 0.010)和强负相关(r = -0.649,P < 0.001)。在VHD组中,EF与抑郁和愤怒之间存在微弱负相关(r = -0.302,P = 0.033和r = -0.240,P = 0.054)。

结论

VHD和CAD表现出不同的心理病理症状和气质特征。上述心理病理症状和气质特征与EF之间存在相关性。

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