摘要
目的:将急性闭角型青光眼患者心理因素,与中国常模及慢性青光眼患者进行对比,分析急性青光眼患者心理及个性特征及其与疾病的关系。方法:选择2003-01/2005-04在大坪医院野战外科研究所眼科住院的重庆市渝中区急性闭角型青光眼患者423例(急性组)及同期接受治疗的346例慢性青光眼患者(慢性组)为观察对象。采用焦虑自评量表(评分<50分为非焦虑,50～59分为轻度焦虑,>60分为中重度焦虑)评定患者焦虑情绪;采用抑郁自评量表(评分<50分为无抑郁,50～59分为轻度抑郁,>60分为中重度抑郁)评定抑郁情绪。采用艾森克个性问卷犤由4个分量表组成,即精神病质(P)、内外向质(E)、神经质(N)和效度量表(L)犦评定患者人格特征;采用症状自评量表(含90个项目可概括为躯体化、强迫、人际关系敏感、抑郁、焦虑、攻击性、恐怖、偏执、精神病性9个因子。分为五级评分,0从无,l轻度,2中度,3相当重,4严重)评定患者心理状态。并与全国常模比较。由经过培训的精神科医师使用统一的指导语,按各量表评定要求进行指导,测试者独立完成问卷。问卷取无记名方式,当场收回。组间进行t检验及相关性检验。结果:急性青光眼患者423例及慢性青光眼患者346例均完成测试,全部进入结果分析。①性别、年龄差异:急性青光眼组患者以女性居多,慢性青光眼组患者则没有明显的性别差异。急性青光眼组基本上集中在60～70岁,慢性青光眼组集中在50～70岁。②焦急、抑郁症状发生情况:急性青光眼组焦虑自评量表及抑郁自评量表评分非常显著高于中国常模,显著高于慢性青光眼组。急性组轻度焦虑率,中重度焦虑率,轻度抑郁率,中重度抑郁率均高于慢性组。③与中国常模数据比较:急性青光眼组表示精神质的P评分和表示神经质的N评分高于中国常模及慢性青光眼组。急性青光眼组除强迫、偏执因子其他因子分均高于中国常模和慢性组。④相关性分析:急性青光眼组患者焦虑自评量表及抑郁自评量表评分与艾森克个性问卷人格精神质P评分、神经质N评分、躯体化、人际关系、精神病性呈显著正相关,与内外倾向E评分及掩饰作用L评分无明显相关。表明急性青光眼患者情绪状态受人格特征影响。结论:急性闭角型青光眼患者人格特征具有明显的精神质,心理症状突出,与正常人及慢性闭角型青光眼患者心理因素有显著差异。
AIM： To compare psychological factors of patients with acute angleclosure glaucoma with the national norm and that of patients with chronic angle-closure glaucoma so as to analyze the relationship of mental profile and personality characteristics of patients with glaucoma. METHODS： From January 2003 to April 2005 in the Department of Ophthalmology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, 423 inpatients in Yuzhong district of Chongqing city suffering from acute angle-closure glaucoma were selected for acute glaucoma group, and 346 synchronous inpatients suffering from chronic an- gle-closure glaucoma were for chronic glaucoma group. Self-rating anxiety scale（SAS, the score less than 50 points is as non-anxiety, from 50 to 59 as mild anxiety, and more than 60 as moderate-severe anxiety） was employed to assess anxiety in the subjects, and self-rating depression scale（SDS, the score less than 50 points is as non-depression, from 50 to 59 as mild depression, and more than 60 as moderate-severe depression） to assess depression. Eysenck personality questionnaire [EPQ, consisting of 4 scales： psychoticism（P）, extraversion（E）, neuroticism（N）, lie（L）] was used to assess the patients＇ personality characteristics; symptom checklist（SCL, 90 items include 9 factors： somatization, obsession, sensitivity of interpersonal relationship, depression, anxiety, aggression, fear, crankiness and psychotic diseases, which are graded from 0 to 4：0 point as be symptomless, 1 point as mild symptom, 2 points as moderate symptom, 3 points as mild severe symptom and 4 points as severe symptom） to assess patients＇ mental status. The assessed results were compared with the national norm. The trained psychiatrists gave uniform instruction based on the assessment of all scales to assist the patients to fill the questionnaires independently. All the questionnaires were nameless, and reclaimed on the spot. The inter-group comparison was performed by t test and related tests. RESULTS： All the 423 patients in acute glaucoma group and 346 in the chronic glaucoma group finished the survey and were analyzed in the resuit. ①Difference in gender and age： Most of the patients in the acute glaucoma group were female, but there was unobvious difference in gender in the chronic glaucoma group. Patients were mainly aged from 60 to 70 ears in the former group, and were from 50 to 70 years in the latter group. The situation of anxiety and depression： The scores of SAS and SDS in the acute glaucoma group were extraordinarily significantly higher than the national norm, and significantly higher than those in the chronic glaucoma group. The rates of mild and moderate-severe anxiety, mild and moderatesevere depression were all higher in the acute glaucoma group than in the chronic glaucoma group. ② In the comparison with the national norm： The P and N scores in EPQ test in the acute glaucoma group were higher than the national norm and those in the chronic glaucoma group. All the scores in the acute glaucoma group were significantly higher than the national norm and those in the chronic glaucoma group, except the scores of obsession and crankiness. ③ Analysis of correlation： The scores of SAS and SDS were in a remarkably positive correlation with the scores of P, N, somatization, interpersonal relationship, psychotic diseases in EPQ, and in an unobvious correlation with the scores of E and L in EPQ. The results indicated that patients with acute angle-closure glaucoma were influenced by their personality characteristics. CONCLUSION： The personality characteristics in patients with acute angle-closure glaucoma possess obvious nervous temperament, and have marked psychological symptoms, which are remarkably different from psychological factors in normal people and patients with chronic angle-closure glaucoma.
出处
《中国临床康复》
CSCD
北大核心
2005年第24期58-60,共3页
Chinese Journal of Clinical Rehabilitation
作者简介
通讯作者：陈鹏，男，1977年生，云南省昆明市人，汉族，解放军第三军医大学大坪医院野战外科研究所眼科在读硕士，医师，主要从事青光眼及糖尿病视网膜病变预防和治疗研究。Chengpengcp@163．com
