Del Río-Casanova Lucía, González-Vázquez Ana Isabel, Justo Ania, Andrade Vanessa, Páramo Mario, Brenlla Julio, Blanco-Hortas Andrés
MD, Psychiatrist, Santiago de Compostela University Hospital, Spain.
PhD, Psychiatrist, A Coruña University Hospital. Spain.
Actas Esp Psiquiatr. 2018 May;46(3):92-103. Epub 2018 May 1.
The role that emotion regulation plays in Conversion Disorders (CD) is not well known. This research deepens in this subject and describes the main differences between a group of conversion patients and a control group on different measures of emotion regulation and other clinical variables.
A case-control study was conducted including 43 patients suffering from CD and 42 healthy controls. Both groups went thought two psychiatric interviews and fulfilled 6 questionnaires assessing depression, anxiety, alexithymia, emotion dysregulation, affect intensity, psychoform and somatoform dissociation.
Patients suffering from CD scored significantly higher on all the six questionnaires (p<0.001). Negative reactivity and negative intensity were also higher in patients (p<0.01), while cases and controls did not show any significant differences on positive affectivity and serenity. Anxiety, alexithymia and emotional dysregulation were the most relevant factors (OR=5.85/3.50/3.23 respectively). Anxiety and difficulties in emotion regulation were the most explicative variables for conversion in the regression analysis performed. Within the five factors assessing difficulties in emotion regulation, lack of emotional control and interference in goal directed behaviors were the most relevant. Positive and negative conversion where correlated to different emotional impairments.
People suffering from CD show several emotional impairments when compared to healthy controls. Emotion dysregulation can be considered a relevant aspect in CD. The existence of specific emotional patterns for different conversion manifestations is suspected.
情绪调节在转换障碍(CD)中所起的作用尚不明确。本研究深入探讨了这一主题,并描述了一组转换障碍患者与对照组在不同情绪调节指标及其他临床变量上的主要差异。
开展了一项病例对照研究,纳入43例转换障碍患者和42名健康对照者。两组均接受了两次精神科访谈,并完成了6份问卷,以评估抑郁、焦虑、述情障碍、情绪失调、情感强度、心理形式和躯体形式解离。
转换障碍患者在所有6份问卷上的得分均显著更高(p<0.001)。患者的消极反应性和消极强度也更高(p<0.01),而病例组和对照组在积极情感和宁静方面未显示出任何显著差异。焦虑、述情障碍和情绪失调是最相关的因素(分别为OR=5.85/3.50/3.23)。在进行的回归分析中,焦虑和情绪调节困难是转换的最具解释力的变量。在评估情绪调节困难的五个因素中,缺乏情绪控制和对目标导向行为的干扰最为相关。阳性和阴性转换与不同的情绪损伤相关。
与健康对照相比,转换障碍患者存在多种情绪损伤。情绪失调可被视为转换障碍的一个相关方面。怀疑不同转换表现存在特定的情绪模式。