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纤维肌痛综合征中疾病严重程度与防御机制的关系。

The relationship between disease severity and defense mechanisms in fibromyalgia syndrome.

作者信息

Berk Ejder, Baykara Sema

机构信息

Department of Physical Medicine and Rehabilitation, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey.

Department of Psychiatry, Fırat University Faculty of Medicine, Elazığ, Turkey.

出版信息

Turk J Phys Med Rehabil. 2020 Mar 3;66(1):47-53. doi: 10.5606/tftrd.2020.3331. eCollection 2020 Mar.

Abstract

OBJECTIVES

The aim of the present study was to investigate the possible relationship between the disease severity and defense mechanisms in fibromyalgia syndrome (FMS) and to contribute to the clarification of the etiopathogenesis of FMS.

PATIENTS AND METHODS

A total of 103 female patients (mean age: 42.6±10.0 years; range, 20 to 67 years) diagnosed with primary FMS based on the 2016 revised American College of Rheumatology (ACR) diagnostic criteria and without any psychiatric diagnosis were included in the study. A semi-structured sociodemographic and clinical data form was used. The Fibromyalgia Impact Questionnaire (FIQ), Defense Style Questionnaire-40 (DSQ-40), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were applied to all patients. Based on the FIQ scores, the patients were divided into two groups as mild-moderate (<70) and severe (≥70) FMS groups.

RESULTS

There were 56 patients in the mild-moderate FMS group and 47 patients in the severe FMS group. As FIQ scores increased, sublimation (r=-0.204, p=0.030) and mature factor (r=-0.229, p=0.020) scores decreased, and projection (r=0.210, p=0.033) and somatization (r=0.287, p=0.003) scores increased. Pseudoaltruism (p=0.043), displacement (p=0.026), and somatization (p=0.021) scores were higher in the severe FMS group. The BDI and BAI scores were also higher in the severe FMS group, compared to the mild-moderate FMS group (p=0.001 and p=0.002, respectively).

CONCLUSION

Our study results show that there is a significant correlation between the increased disease severity, decreased mature defense mechanisms, and increased immature defense mechanisms in FMS patients.

摘要

目的

本研究旨在探讨纤维肌痛综合征(FMS)的疾病严重程度与防御机制之间的可能关系,并有助于阐明FMS的病因发病机制。

患者与方法

本研究纳入了103例女性患者(平均年龄:42.6±10.0岁;范围20至67岁),这些患者根据2016年修订的美国风湿病学会(ACR)诊断标准被诊断为原发性FMS,且无任何精神疾病诊断。使用了一份半结构化的社会人口统计学和临床数据表格。对所有患者应用纤维肌痛影响问卷(FIQ)、防御方式问卷-40(DSQ-40)、贝克抑郁量表(BDI)和贝克焦虑量表(BAI)。根据FIQ评分,将患者分为轻度-中度(<70)和重度(≥70)FMS两组。

结果

轻度-中度FMS组有56例患者,重度FMS组有47例患者。随着FIQ评分增加,升华(r=-0.204,p=0.030)和成熟因子(r=-0.229,p=0.020)评分降低,而投射(r=0.210,p=0.033)和躯体化(r=0.287,p=0.003)评分增加。重度FMS组的假性利他主义(p=0.043)、转移(p=0.026)和躯体化(p=0.021)评分更高。与轻度-中度FMS组相比,重度FMS组的BDI和BAI评分也更高(分别为p=0.001和p=0.002)。

结论

我们的研究结果表明,FMS患者疾病严重程度增加、成熟防御机制降低和不成熟防御机制增加之间存在显著相关性。

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引用本文的文献

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2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria.2016年对2010/2011年纤维肌痛诊断标准的修订。
Semin Arthritis Rheum. 2016 Dec;46(3):319-329. doi: 10.1016/j.semarthrit.2016.08.012. Epub 2016 Aug 30.
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EULAR revised recommendations for the management of fibromyalgia.EULAR 修订的纤维肌痛管理建议。
Ann Rheum Dis. 2017 Feb;76(2):318-328. doi: 10.1136/annrheumdis-2016-209724. Epub 2016 Jul 4.
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Worldwide epidemiology of fibromyalgia.纤维肌痛的全球流行病学。
Curr Pain Headache Rep. 2013 Aug;17(8):356. doi: 10.1007/s11916-013-0356-5.
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Cognitive impairment in fibromyalgia.纤维肌痛症的认知障碍。
Curr Pain Headache Rep. 2013 Jul;17(7):344. doi: 10.1007/s11916-013-0344-9.
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