【摘要】 目的:探讨绝经期骨质疏松症妇女的精神、心理和行为特征,并与健康人进行比较。方法:选择2002-02/2004-05在中国医科大学附属第一医院进行全面体检的被确诊为骨质疏松症者的绝经期妇女50例。同期选择本院体检各项指标均正常的绝经期妇女50例为对照组。对两组对象进行问卷调查:①采用明尼苏达多相人格问卷评估精神状态(14个量表,先得出各量表的粗分,再将各量表粗分换算成T分,得分越高精神状态越不好)。②采用症状自评量表评估心理状态(90多项内容,9大症状因子,5级评分制:0为从无,l为轻度异常,2为中度异常,3为相当重异常,4为严重异常)。③采用A型性格问卷评估行为类型(该问卷有3个分量表,共有60个小题。将时间紧迫感,争强好胜,怀有戒心和敌意两个分量表的评分相加即得到A型行为总分,总分≥31分为典型的A型行为,≤23分为典型的B型行为,24～30分为中间型),按其要求进行测定和记分。结果:50例骨质疏松症患者和50例健康对照组均进入结果分析。①明尼苏达多相人格问卷评分结果比较:骨质疏松症组疑病症、抑郁症、偏执、精神衰弱、社会内向性评分均明显高于对照组犤(69.7±6.9),(53.7±5.5)分;(65.3±6.5),(53.5±5.9)分;(50.2±4.8),(56.0±4.5)分;(67.1±3.3),(55.1±3.1)分;(69.8±5.5),(62.1±5.2)分,(t=3.134～2.316,P<0.05)犦。②症状自评量表评分结果比较:骨质疏松症组患者的躯体化、强迫、人际关系、抑郁、焦虑、偏执等因子评分均明显高于对照组犤(2.06±0.72),(1.43±0.50)分;(2.23±0.39),(1.66±0.48)分;(1.86±0.32),(1.45±0.40)分;(2.14±0.56),(1.65±0.49)分;(2.15±0.40),(1.40±0.51)分;(1.69±0.32),(1.45±0.30)分,t=2.796～2.356,P<0.05犦。③A型性格问卷评分结果比较:骨质疏松症组中时间紧迫感,争强好胜、怀有戒心或敌意,总分均明显高于对照组犤(24.75±4.45),(14.01±3.49)分;(21.13±3.28),(15.47±3.19)分;(40.19±6.61),(32.57±4.36)分,t=2.437～2.782,P<0.05犦。结论:绝经期妇女骨质疏松症发病与疑病症、抑郁症、偏执、精神衰弱、社会内向性、躯体化、强迫、人际关系、抑郁、焦虑、偏执、时间紧迫感,争强好胜、怀有戒心或敌意等精神、心理和行为特征有关,其中有些症状可以认定为是绝经期骨质疏松症妇女临床表现的组成部分。更多还原

【Abstract】 AIM: To investigate the mental and psychological characters of women with menopausal osteoporosis as compared with healthy people.METHODS: Totally 50 women with menopausal osteoporosis were selected from the First Hospital Affiliated to China Medical University from February 2002 to May 2004. Another 50 menopause women with normal items in health examination were also selected as control group at synchronization. Questionnaires were surveyed on all the subjects in the two groups: ① Mental state was assayed with Minnseota Multiphasic Personality Inventory (MMPI), consisting of 14 subscales. Raw scores were obtained firstly, and then were changed into T scores. The higher points were, the poorer mental state was. ② Psychological state was measured with Symptom Chechlist-90 (SCL-90), including more than 90 items (9 symptom factors and 5 score grade: 0 as none, 1 as mild, 2 as moderate, 3 as quite severe and 4 as highly severe). ③ Type of behavior was evaluated with Type A Behavior Pattern Scale (TABP), including 3 subscales and 60 items. The scores of time urgency, desiring to excel over others, vigilance and hostility were added together to obtain the total TABP score: ≥ 31 points determined as type A, ≤ 23 as type B, 24-30 as the middle type. According to TABP, scores of the objects were assayed and recorded.RESULTS: All 50 patients with osteoporosis and 50 healthy people entered the final analysis. ①Comparison of MMPI: Scores in the osteoporosis group including hypochondria, depression, paranoid ideation, psychasthenia and social autism were obviously higher than those in the control group [(69.7±6.9), (53.7±5.5) points; (65.3±6.5), (53.5±5.9) points; (50.2±4.8), (56.0±4.5) points; (67.1±3.3), (55.1±3.1) points; (69.8±5.5), (62.1±5.2) points, t=3.134-2.316, P < 0.05]. ② Comparison of SCL-90: Scores in the osteoporosis group including somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, paranoid ideation, etc. were obviously higher than those in the control group [(2.06±0.72), (1.43±0.50) points; (2.23±0.39), (1.66±0.48) points; (1.86±0.32), (1.45±0.40) points; (2.14±0.56), (1.65±0.49) points; (2.15±0.40), (1.40±0.51) points; (1.69±0.32), (1.45±0.30) points, t=2.796-2.356, P < 0.05]. ③ Comparison of TABP: Scores in the osteoporosis group including time urgency, desiring to excel over others, vigilance or hostility were obviously higher than those in the control group [(24.75±4.45), (14.01±3.49) points; (21.13±3.28), (15.47±3.19) points; (40.19±6.61), (32.57±4.3) points, t=2.437-2.782, P < 0.05].CONCLUSION: Onset of osteoporosis in menopause women is related to the mental and psychological behaviors, such as hypochondria, depression, paranoid ideation, psychasthenia, social autism, somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, paranoid ideation, time urgency, desiring to excel over others, vigilance and hostility. Among them, some symptoms can be determinate as clinical manifestations of menopausal osteoporosis.更多还原