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疑病症和抑郁症中的情绪失调。

Emotion dysregulation in hypochondriasis and depression.

机构信息

Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University Heidelberg, Mannheim, Germany.

Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, University of Mainz, Mainz, Germany.

出版信息

Clin Psychol Psychother. 2017 Nov;24(6):1254-1262. doi: 10.1002/cpp.2089. Epub 2017 Apr 26.

Abstract

BACKGROUND

The aim of this study was to explore whether certain aspects of emotion dysregulation (i.e., facets of alexithymia and rumination) are more closely linked to hypochondriasis than to depression and vice versa.

METHODS

Nineteen patients with hypochondriasis (HYP), 33 patients with depression, and 52 healthy control participants completed the Toronto Alexithymia Scale, the Response Styles Questionnaire, and additional symptom and illness behaviour scales. A clinical interview was used to establish DSM-IV diagnoses and to exclude all cases with more than one axis I diagnosis.

RESULTS

Depression patients reported more difficulties describing feelings and more symptom- and self-focused rumination than both HYP patients and healthy individuals, whereas HYP patients differed only from healthy individuals in regard to more difficulties in identifying feelings and more symptom-focused rumination. Multiple regression analyses, including all assessed facets of emotion dysregulation, showed that the degree of somatoform features (somatic symptoms, health anxiety, and illness behaviour) was specifically predicted by higher difficulties in identifying feelings scores, whereas depressive symptom levels were specifically predicted by higher rumination scores.

CONCLUSIONS

Specific associations were found between difficulties in identifying feelings and key features of HYP, whereas depression was linked to a more generalized pattern of emotion regulation deficits.

KEY PRACTITIONER MESSAGE

Emotion dysregulation can be found in hypochondriasis and depression Difficulties in identifying own feelings are specifically linked to somatic symptoms, health anxiety, and illness behaviour, whereas a more generalized pattern of emotion dysregulation is found in relation to depression Further research is needed to investigate whether the effectiveness of current treatments for depression, hypochondriasis, health anxiety, and related disorders could be improved by additional emotion regulation interventions.

摘要

背景

本研究旨在探讨情绪失调的某些方面(即述情障碍和反刍的各个方面)与疑病症的关系是否比与抑郁症更为密切,反之亦然。

方法

19 名疑病症患者(HYP)、33 名抑郁症患者和 52 名健康对照者完成了多伦多述情障碍量表、反应风格问卷以及其他症状和疾病行为量表。临床访谈用于确定 DSM-IV 诊断并排除所有有一个以上轴 I 诊断的病例。

结果

抑郁症患者报告的描述感受困难和更关注症状和自我的反刍比 HYP 患者和健康个体多,而 HYP 患者仅在识别感受困难和更关注症状的反刍方面与健康个体不同。包括情绪失调所有评估方面的多元回归分析表明,躯体形式特征(躯体症状、健康焦虑和疾病行为)的严重程度与识别感受困难的程度呈正相关,而抑郁症状水平与反刍得分呈正相关。

结论

在识别感受困难与疑病症的关键特征之间发现了特定的关联,而抑郁与更广泛的情绪调节缺陷模式有关。

主要实践意义

在疑病症和抑郁症中都可以发现情绪失调,识别自身感受的困难与躯体症状、健康焦虑和疾病行为特异性相关,而与抑郁症相关的是更广泛的情绪失调模式。需要进一步研究以探讨当前针对抑郁症、疑病症、健康焦虑和相关障碍的治疗方法是否可以通过额外的情绪调节干预来提高疗效。

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