【摘要】 目的:根据ICD-10诊断标准,探讨中日两国神经症患者在患者构成和临床症状表现上的差异。方法:从北京大学精神卫生研究所收集神经症患者1414例,东京慈惠会医科大学附属精神神经科门诊收集神经症患者943例。均从门诊病历中收集首诊神经症患者及其有关信息。以九州大学神经症症状评定量表为评定工具。结果:中国患者以焦虑性障碍最多(35%),其次是强迫性障碍(25.9%)。日本患者以严重应激反应及适应障碍的人群最多(32.8%),其次是焦虑性障碍(28.5%)。中国和日本首诊神经症患者的症状构成比都以焦虑症状为主,但日本首诊神经症患者焦虑症状比率高于中国患者(70.7%/65.1%,χ2=32.38,P<0.001)。中国患者的适应障碍、躯体化障碍、广泛性焦虑障碍、混合性焦虑和抑郁障碍、严重应激反应比率低于日本患者(2.4%/27.0%,16.0%/19.2%,8.9%/13.7%,1.4%/3.0%,0.2%/5.8%,均P<0.05),中国患者的惊恐障碍、其他混合性焦虑障碍、强迫性障碍、神经衰弱症状比率高于日本患者(18.0%/11.3%,5.2%/0.2%,25.9%/9.0%,9.2%/0.1%,均P<0.05)。中国患者的攻击性、污染的强迫观念比率低于日本患者(29.3%/43.8%,5.6%/13.8%,χ2=6.42、6.83、P=0.011、0.009)。中国患者的宗教性强迫症状、对称性与确认性强迫症状等比率高于日本患者(8.6%/1.3%,22.7%/10.0%,χ2=5.24、6.63,P=0.022、0.009)。中国患者的清扫和清洗、整理收拾症状比率低于日本患者(27.6%/40.0%,2.7%/12.5%,χ2=4.91、15.67,P=0.027、0.000)。中国患者的确认行为比率高于日本患者(43.5%/23.8%,χ2=10.87,P=0.001)。中国患者的回避(5.00%/0.53%,P=0.007)行为患者比率低于日本患者。中国患者的自伤行为、自杀企图、病理性购物等比率高于日本患者(5.3%/0,3.7%/0.38%,9.0%/3.5%,P=0.000、0.011、0.013)。中国患者的不愿上学/上班、消极倾向症状比率低于日本(0/3.85%,0/2.69%,P=0.006、0.024)。结论:中日两国神经症患者的疾病构成有所不同,可能与两国社会文化的差异有关。更多还原

【Abstract】 Objectives:To explore the difference of neurotic symptoms and the component of neuroses between China and Japan using diagnostic criteria such as ICD.Methods:Two university hospitals were selected respectively from Beijing and Tokyo.Relevant information was gathered from neurotic outpatients using a particularly designed questionnaire.Kyushu University Scale for Neurosis was used as evaluation tools.Results:Totally,2357 patients were investigated,of them 1414 in Beijing and 943 in Tokyo.In the newly diagnosed neurotic outpatients,the first two most common symptoms in Japanese patients were adjustment disorder(32.8%) and anxiety(28.5%),that of Chinese patients were anxiety disorder(35%) and obsessive disorder(25.9%),with a significant difference existing between two groups.The frequency of patients with Anxiety were significantly higher in Japan group than in China group(70.7% vs 65.1%,χ2=32.38,P<0.001),although in both groups anxiety claimed a leading place as a major symptom.Regarding obsession,aggressive obsession and contamination obsession were more common in Japanese group than in Chinese group(43.8%/29.3%,13.8%/5.6%,χ2=6.42,6.83,P=0.011、0.009),while religious obsession and obsession with need for symmetry or exactness were more common in Chinese group(8.6%/1.3%,22.7%/10.0%,χ2=5.24、6.63,P=0.022、0.009).Neurotic patients in Japanese group were more likely to have compulsive behaviors as cleaning and washing and ordering and arranging(40.0%/27.6%,12.5%/2.7%,χ2=4.91、15.67,P=0.027、<0.001),while its Chinese counterpart were more likely to have checking compulsion(43.5%/23.8%,χ2=10.87,P=0.001).Two groups also showed difference in problematic behavior,with more keeping-indoors(3.85%/0,χ2=7.20,P=0.007)in Japanese group and self-injuring in Chinese group(5.3%/0,P<0.001).Conclusions:In Chinese and Japanese neurotic patients there are definite differences of the presence of symptoms,which may be attributed to the underling variance in cultural and social characteristics.更多还原