抽動(dòng)穢語(yǔ)綜合征患者父母的情感表達(dá)及其對(duì)患者治療效果的影響

吳元貞,鄭毅,崔永華

·論著·

抽動(dòng)穢語(yǔ)綜合征患者父母的情感表達(dá)及其對(duì)患者治療效果的影響

吳元貞,鄭毅,崔永華

目的探討抽動(dòng)穢語(yǔ)綜合征(TS)患者父母的情感表達(dá)(EE)及其對(duì)患者治療效果的影響。方法對(duì)61例TS患者給予阿立哌唑治療8周,治療前后進(jìn)行耶魯綜合抽動(dòng)嚴(yán)重程度量表(YGTSS)測(cè)評(píng),治療后患者YGTSS減分率≥50%為有效。對(duì)TS患者父母進(jìn)行坎伯威爾家庭問(wèn)卷(CFI-CV)評(píng)估,并據(jù)此將患者家庭分為低EE家庭和高EE家庭；分析患者父母EE對(duì)TS患者治療效果的影響。結(jié)果TS患者的父親和母親在對(duì)患者情感表達(dá)上差異有統(tǒng)計(jì)學(xué)意義。Logistic回歸分析顯示,中度以下情感表達(dá)是TS治療效果的有利因素,而TS患者父親的敵對(duì)或者拒絕的家庭監(jiān)護(hù)及母親的敵對(duì)是TS治療效果的不利因素。結(jié)論TS患者父母的情感表達(dá)有差異,并且影響治療效果。

抽動(dòng)穢語(yǔ)綜合征； 情感表達(dá)； 教養(yǎng)方式； 治療效果

Abstract：Objective： To explore parents' expressed emotion of patients with Tourette syndrome(TS) and its influence on therapeutic effect.Method：Sixty one TS patients who received aripiprazole treatment were assessed using Yale global Tie severity scale (YGTSS) at the baseline and week 8.The treatment was effectiive if YGTSS score deducted rate ≥50% through the treatment.Camberwell family interview-Chinese version(CFI-CV) was adminstered to their parents.The parents were grouped into high and low emotional expression according to CFI-CV scores.The influence of the parents' emotional expression on therapeutic effects was analyzed.Results：There was statistical significance between the fathers and mothers' emotional expression for TS patients.Logistical regression result indicated that lower expressed emotion of parents was protective factor,the parents' hostility and fathers' rejection were risk factor for TS treatment effect.Conclusion：The TS parents' emotional expression demonstrates different features and can affect the therapeutic effects.

Keywords： Tourette syndrome; parenting style; expressed emotion; therapeutic effect

抽動(dòng)穢語(yǔ)綜合征(TS)是常見的少年兒童慢性神經(jīng)精神性疾病之一[1-4],病因不明[5-6]。研究表明[7],抽動(dòng)障礙患者家庭的情緒氣氛、教養(yǎng)方式和家庭結(jié)構(gòu)等對(duì)其心理健康的發(fā)展均產(chǎn)生重要影響。本研究對(duì)TS患者父母的情感表達(dá)(EE)特點(diǎn)及其對(duì)治療效果的影響進(jìn)行分析。

1 對(duì)象和方法

1.1 對(duì)象

為2015年3月至12月就診于本院兒童精神科門診的TS患者及其主要家屬。入組標(biāo)準(zhǔn)： ①TS患者符合《美國(guó)精神障礙診斷與統(tǒng)計(jì)手冊(cè)》第4版(DSM-IV)診斷標(biāo)準(zhǔn)；② 年齡6～18歲；③長(zhǎng)期與父母一起生活；④TS患者及其父母對(duì)本研究知情同意。排除標(biāo)準(zhǔn)：①排除風(fēng)濕性舞蹈病、Huntington舞蹈癥、肝豆?fàn)詈俗冃?、肌陣攣手足徐?dòng)癥、藥源性不自主運(yùn)動(dòng)和其他錐體外系病變等神經(jīng)系統(tǒng)疾病及不合作者；……