背景青光眼属于心身疾病，了解青光眼患者的精神心理及性格行为特征对与完善青光眼的防治方案和策略具有重要的临床意义。
目的调查和分析初诊为原发性开角型青光眼(POAG)及原发性闭角型青光眼(PACG)患者的心理、个性和行为特征。
方法采用前瞻性分析方法，收集2008年1月至2014年5月在北京大学人民医院眼科初诊的POAG患者87例、PACG患者92例及健康体检者89名，3个组受试者年龄、性别及受教育的程度匹配。在受试者的知情同意下，分别运用症状自评量表(SCL-90)、生活事件量表(LES)、艾森克个性间卷(EPQ)、焦虑自评量表(SAS)和抑郁自评量表(SDS)对所有受试者进行调查评估。
结果SCL-90量表中，3个组受试者的强迫、人际关系、抑郁、焦虑、恐怖、偏执、精神病性等症状评分和SCL-90量表总分的差异均有统计学意义(均 P<0.01)，其中POAG组和PACG组患者的各项症状评分均明显高于正常对照组，PACG组患者的抑郁和焦虑症状评分明显高于POAG组患者，差异均有统计学意义(均 P<0.05)。LES量表中，3个组间家庭事件、社会及其他事件、生活事件总分和压力总分的差异均有统计学意义( P＝0.032、0.002、0.001、0.000)，其中POAG组和PACG组患者各项评分均明显高于正常对照组，而PACG组患者生活事件总分和压力反应总分均明显高于POAG组，差异均有统计学意义(均 P<0.05)。EPQ调查问卷显示，POAG组和PACG组患者仅有精神质和神经质评分明显高于正常对照组，差异均有统计学意义(均 P<0.05)，而3个组间外向性和人格稳定性评分差异均无统计学意义( P＝0.321、0.315)。POAG组及PACG组患者SAS量表总分和SDS量表总分均明显高于正常对照组，且PACG组患者明显高于POAG组，差异均有统计学意义(均 P<0.05)。POAG组及PACG组患者焦虑和抑郁发生率均明显高于正常对照组，3个组间比较差异均有统计学意义( χ 2＝15.520， P＝0.000； χ 2＝14.870， P＝0.000)。
结论性格行为因素与原发性青光眼的发病、进展和治疗效果有一定的关联，PACG患者的焦虑、抑郁等症状评分以及生活事件及压力反应总评分明显高于POAG患者和正常人。
BackgroundGlaucoma is a kind of psychosomatic disorder.Investigating the psychological and behavioral characteristics of glaucoma patients has important implication for the prevention and treatment of the disease.
ObjectivePresent study aimed to characterize the personality profile of initial diagnosed glaucomatous patients.
MethodsEighty-seven patients with primary open angle glaucoma (POAG), ninety-two patients with primary angle-closure glaucoma (PACG) and eighty-nine normal controls (normal control group) were enrolled in this study from January 2008 to May 2014 in Peking University People's Hospital.Clinical and demographic information which could relate to personality type was collected by filling in Symptom Checklist 90 (SCL-90), Life Event Scale (LES), Eysenck Personality Questionnaire (EPQ), Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) voluntarily under the informed consent.The psychological, personality and behavior characteristics of the individuals were analyzed and compared among the different populations.
ResultsIn SCL-90, the scores of compulsivity, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism inpatients with primary glaucoma were significant different among the three groups (all at P<0.01), and the scores were significantly higher in the patients of the POAG group and PACG group than those in the normal control group, and the scores were increased in the PACG group compared with the POAG group (all at P<0.05). In LES, the scores of family events, social intercourse and other events, life events, stress response were significantly different among the three groups ( P=0.032, 0.002, 0.001, 0.000), and these scores were significant higher in the POAG group and PACG group compared with the normal control group, and the PACG group also had a significantly greater frequency of clinically abnormal score than the POAG group (all at P<0.05). EPQ data showed that the scores of psychology and nervousness in the POAG group and the PACG group were higher than those in the normal control group (all at P<0.05), but no significant difference were found in extroversion and stability of the personality among the three groups ( P=0.321, 0.315). The total scores of SAS and SDS were considerably higher in the POAG group and the PACG group compared with the normal control group or the PACG group compared with the POAG group (all at P<0.05). The incidences of anxiety and depression were elevated in the POAG group and the PACG group in comparison with the normal control group ( x 2=15.520, P=0.000; x 2=14.870, P=0.000).
ConclusionsThe personality and behavioral factors are associated with the pathogenesis, development and therapy of primary glaucoma.The anxiety, depression and stronger stress response are found in glaucoma patients, especially PACG patients.
刘佳,李岩. 原发性青光眼初诊患者心理特征的调查量表分析[J]. 中华实验眼科杂志,2015,33(3)：255-258.
DOI:10.3760/cma.j.issn.2095-0160.2015.03.014版权归中华医学会所有。
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