抑郁型冠心病患者伴或不伴 D 型人格特征的精神障碍患病率。多中心 SPIRR-CAD 试验结果。
Prevalence of mental disorders among depressed coronary patients with and without Type D personality. Results of the multi-center SPIRR-CAD trial.
机构信息
Dept. of Psychosomatics and Psychotherapy, University of Cologne, Germany.
Dept. of Psychosomatic Medicine and Psychotherapy, University of Goettingen Medical Center, Germany; German Center for Cardiovascular Research (DZHK), partnersite Göttingen, Germany.
出版信息
Gen Hosp Psychiatry. 2018 Jan-Feb;50:69-75. doi: 10.1016/j.genhosppsych.2017.10.001. Epub 2017 Oct 7.
OBJECTIVE
Type D personality, as with formal mental disorders, is linked to increased mortality in coronary heart disease (CHD). Our aim was to determine the prevalence of mental disorders among depressed CHD patients with and without Type D personality.
METHODS
Depressive symptoms (HADS, HAM-D), Type D personality (DS-14) and mental disorders based on DSM-IV (SCID I and II) were assessed. Results were calculated by Kruskal-Wallis tests, Fisher's exact tests and logistic regression analyses.
RESULTS
570 CHD patients were included (age 59.2±9.5years; male 78.9%, HADS-D depression 10.4±2.5; HAM-D 11.3±6.6; Type D 60.1%). 84.8% of patients with Type D personality and 79.3% of non-Type D patients suffered from at least one mental disorder (p=0.092), while 41.8% of Type D positives and 27.8% of Type D negatives had at least two mental disorders (p=0.001). Patients with Type D personality significantly more often had social phobia [odds ratio (95% confidence interval): 3.79 (1.1 to 13.12); p=0.035], dysthymia [1.78 (1.12 to 2.84); p=0.015], compulsive [2.25 (1.04 to 4.86); p=0.038] or avoidant [8.95 (2.08 to 38.49); p=0.003] personality disorder.
CONCLUSIONS
Type D personality among depressed CHD patients is associated with more complex and enduring mental disorders. This implies higher treatment demands.
TRIAL REGISTRATION
ISRCTN 76240576; NCT00705965.
目的
与正式精神障碍一样，D 型人格与冠心病（CHD）死亡率增加有关。我们的目的是确定伴有和不伴有 D 型人格的抑郁性 CHD 患者中精神障碍的患病率。
方法
评估抑郁症状（HADS、HAM-D）、D 型人格（DS-14）和基于 DSM-IV 的精神障碍（SCID I 和 II）。结果通过 Kruskal-Wallis 检验、Fisher 精确检验和逻辑回归分析进行计算。
结果
共纳入 570 例 CHD 患者（年龄 59.2±9.5 岁；男性 78.9%，HADS-D 抑郁 10.4±2.5；HAM-D 11.3±6.6；D 型 60.1%）。有 D 型人格的患者中 84.8%和无 D 型人格的患者中 79.3%至少患有一种精神障碍（p=0.092），而 D 型阳性患者中 41.8%和 D 型阴性患者中 27.8%至少患有两种精神障碍（p=0.001）。D 型人格患者更常患有社交恐惧症[优势比（95%置信区间）：3.79（1.1 至 13.12）；p=0.035]、心境恶劣[1.78（1.12 至 2.84）；p=0.015]、强迫[2.25（1.04 至 4.86）；p=0.038]或回避[8.95（2.08 至 38.49）；p=0.003]人格障碍。
结论
伴有抑郁的 CHD 患者中的 D 型人格与更复杂和持久的精神障碍相关。这意味着更高的治疗需求。
临床试验注册
ISRCTN 76240576；NCT00705965。
Zotero 插件