焦虑障碍患者人格特征与临床症状相关性: 一项基于回顾性队列的研究

Association between personality traits and clinical symptoms in patients with anxiety disorders: a retrospective cohort study

摘要:

目的描述焦虑障碍患者人格特征，探讨人格特征与临床症状的关联。 方法本研究为回顾性研究，纳入从2009年2月—2023年3月在上海交通大学医学院附属第一人民医院医学心理科门诊初次就诊的焦虑障碍患者共6 814例及健康对照组586名。研究收集两组的人口学资料，并使用艾森克人格问卷(Eysenck Personality Questionnaire, EPQ)评估两组人格特征，症状自评量表(Symptom Checklist 90, SCL-90)评估临床症状。 采用协方差分析与t检验比较组间差异，使用偏相关分析探索EPQ与SCL-90的相关性，使用单因素方差分析、t检验、Pearson相关性分析探索人口学因素与量表结果的关联。 结果与健康对照组相比，焦虑障碍患者“神经质”得分更高(13.63±5.88 vs 13.03±6.42, P＜0.01)，“外向性”得分更低(8.54±4.68 vs 9.04±4.85, P＜0.05)。患者组SCL-90躯体化、焦虑、恐怖因子分更高，而人际敏感、敌对、偏执、精神病性得分相对较低(P<0.05)。患者组“神经质”得分与SCL-90各项分量表得分均呈显著正相关(r=0.43~0.62，均P<0.01)，而“外向性”得分与SCL-90分量表得分呈负相关(r=-0.20~-0.07，均P<0.01)。未婚、年龄较低、教育程度较高人群SCL-90得分更高。 结论焦虑障碍患者在人格上表现高神经质及低外向性特征，更高的神经质及更低的外向性水平与更严重的临床症状相关。具有此人格特质的未婚、年龄较小、教育程度较高的人群为高风险人群，应及时识别并进行必要的干预和治疗。

Abstract:

ObjectiveTo describe the personality traits of patients with anxiety disorders and evaluate their relation to psychosocial status. MethodsThis retrospective study included 6 814 adult patients with anxiety disorders who had their first outpatient visit at the Department of Psychological Medicine at Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, from February 2009 to March 2023. A total of healthy people were set as controls. The demographic and psychometric information from the two groups were gathered. The Eysenck Personality Questionnaire(EPQ) and the Symptom Checklist 90(SCL-90) were applied to assess their personality characteristics and clinical symptoms separately. The t-test and Analysis of Covariance(ANCOVA) was used to compare the results of patients with control group. After controlling for demographic factors, partial correlation analysis was applied to explore the relationship between SCL-90 and EPQ results. Meanwhile, the analysis of variance, t-test and Pearson correlation analysis were applied to investigate the relationship between demographic data and the SCL-90 and EPQ results. ResultsPatients with anxiety disorders scored higher on “neuroticism” [(13.63±5.88) vs (13.03±6.42) points] and lower on “extraversion” [(8.54±4.68) vs (9.04±4.85) points] when compared with those in control group(both P<0.05). The patients scored higher on SCL-90 subscale than the controls, such as “somatization” “anxiety” and phobia, while lower on “interpersonal sensitivity” “hostility” “paranoid” and “psychotic symptom”. Besides, it indicated that neuroticism scores were significantly positively correlated with all SCL-90 subscales(r ranged from 0.43 to 0.62, all P<0.01), while extraversion scores showed slight negative correlations with these SCL-90 subscales(r ranged from -0.20 to -0.07, all P<0.01). Higher SCL-90 scores were associated with certain demographic characteristics: being younger, having a higher level of education, and being unmarried. ConclusionPatients with anxiety disorders exhibited higher levels of neuroticism and low extraversion personality traits, which are related to more severe clinical symptoms on a variety of dimensions. More attention should be paid to the young, single, more educated population.