躯体形式障碍患者心智理论特点及其与述情障碍的相关性研究

Association between alexithymia and theory of mind in patients with somatoform disorder

摘要:

目的 探究躯体形式障碍（SD）患者心智理论（ToM）功能的特征及与述情障碍的相关性。方法 选择30 例年龄在18 ～ 60 岁符合《美国精神障碍诊断与统计手册第4 版》诊断标准的躯体形式障碍患者作为研究组，选择年龄、性别及教育水平相匹配的30 例正常健康者作为对照组。两组均给予评估失言察觉任务测试（FPR）、Yoni 任务测试及多伦多述情障碍20 个条目量表（TAS-20）评定，对两组所测得结果加以比较，并对研究组的FPR、Yoni 任务评分与TAS-20 评分进行相关性分析。结果 两组间比较，研究组的FPR 总分、失言故事分及控制故事分和Yoni 任务测试的Cog、Cog2、Aff、Aff1 及Aff2 评分均低于对照组，两组间的Yoni 任务测试Cog1、Phy、Phy1 及Phy2 评分比较，差异无统计学意义（P >0.05）；研究组FPR 总分、失言故事分与TAS-20 总分及各因子分的相关性分析均呈负相关（P <0.05）；Yoni 任务测试的Cog 及Aff 各因子分与TAS-20 总分、各因子分的相关性分析均呈负相关（P <0.05）。结论 SD 患者的心智理论能力明显受损，且与述情障碍有关。

Abstract:

Objective To investigate the association between alexithymia and theory of mind (ToM) in patients with somatoform disorder. Methods Thirty patients with the age of 18-60 years who met the diagnostic criteria of DSM-IV for somatoform disorders were recruited as research group, and 30 normal healthy people were selected as control group. There was no significant difference in age, education level or course of disease between the two groups. Faux Pas Recognition (FPR) test and Yoni Task test were employed to investigate theory of mind in the two groups. Toronto Alexithymia Scale-20 (TAS-20) was employed to investigate the alexithymia of the subjects. The results of the two groups were compared and correlation analyses were conducted. Results In the FPR test, the Faux Pas questions score, control questions score and total score of FPR in the patients with somatoform disorder were significantly lower than those in the normal controls (P < 0.05). In Yoni Task test, cognitive theory of mind total score (Cog) and cognitive ToM second-level score (Cog2) and total score of affective theory of mind (Aff) and affective theory of mind first-level score (Aff1) and affective ToM second-level score (Aff2) in the patients with somatoform disorder were significantly lower than those in the normal controls (P < 0.05), while Cog1 and total score of control theory of mind (Phy) and control theory of mind first-level score (Phy1) and control theory of mind second-level score (Phy2) were not significantly different between the two groups (P > 0.05). In the research group, the Faux Pas questions score and FPR’s total score were negatively correlated with the total score and each factor score of TAS-20 (P < 0.05). In Yoni Task test, the individual factor scores of Cog and Aff were negatively correlated with the total score and individual factor scores of TAS-20 (P < 0.05). Conclusions Theory of mind in somatoform disorder patients is obviously impaired. It is associated with alexithymia in somatoform disorder.