躯体症状、功能和1型双相情感障碍:童年创伤的作用

N. U. Usta Sağlam
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摘要

目的:躯体症状具有异质性,不能完全用一种医学状况来解释,在1型双相情感障碍(BD-1)中很常见,这可能会干扰治疗的选择、医疗保健的利用、医疗费用以及功能。本研究的目的是评估缓解的BD-1患者躯体症状与社会人口学-临床特征、功能和童年创伤的关系。方法:排除内科合并症患者后,根据《精神障碍诊断与统计手册》诊断为BD-1的患者61例参与研究。我们要求至少8周的缓解,并用汉密尔顿抑郁评定量表和青年躁狂症评定量表证实。采用躯体化量表、功能评估短测试(FAST)和儿童创伤问卷(CTQ)对被试进行问卷调查。结果:躯体化评分与CTQ-total (r=0.323, p=0.011)、FAST-total (r=0.278, p=0.03)呈显著相关,与受教育年限呈负相关(r=-0.395, p=0.002)。在控制童年创伤因素的情况下,采用部分相关分析确定躯体化与功能之间的关系,躯体化与功能之间的相关性无统计学意义(p=0.076)。结论:本研究提示童年创伤可能影响BD-1患者躯体化与功能的关系。在处理双相障碍患者的躯体症状时,应考虑包括童年创伤在内的综合方法。
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Somatic symptoms, functionality, and bipolar disorder type 1: The role of childhood trauma
Objective: Somatic symptoms, with the heterogeneous character that are not fully explained by a medical condition, are common in bipolar disorder type-1 (BD-1) which might interfere with the choice of treatment, health-care utilization, medical costs as well as functionality. The purpose of this study was to evaluate association of somatic symptoms with sociodemographic-clin-ical features, functionality, and childhood trauma in remitted BD-1. Method: After excluding patients with medical comorbidities, 61 patients diagnosed with BD-1 according to the diagnostic and statistical manual of mental disorders participated in the study. We required at least 8 weeks of remission and confirmed it with hamilton depression rating scale and young mania rating scale. Somatization Scale, functioning assessment short test (FAST), and childhood trauma questionnaire (CTQ) were administered to the participants. Results: Somatization scores were significantly correlated with CTQ-total (r=0.323, p=0.011) and FAST-total (r=0.278, p=0.03), while inversely correlated with years in education (r=-0.395, p=0.002). When a partial correlation was run to determine the relationship between somatization and functioning, while controlling for childhood trauma, there was no statistically significant correlation between somatization and functioning (p=0.076). Conclusion: Our study suggests that childhood trauma may have an influence on the relationship between somatization and functionality in patients with BD-1. When addressing somatic symptoms in patients with BD, an integrated approach including childhood trauma should be considered.
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