甲状腺癌患者手术前后心理健康状况与人格相关性分析

陈允恩王长奇①姜宝顺①胡月明②彭焱王莹李丽娜杜君朱小茼程淑英

(华北理工大学心理学院河北唐山063000；①开滦精神卫生中心；②唐山工人医院)

[摘要]①目的探讨甲状腺癌患者心理健康水平和人格特征。②方法采用症状自评量表(SCL-90)对60例甲状腺癌患者术前和术后心理健康状况进行测量。术前采用艾森克个性问卷(EPQ)对患者人格状况进行测量。对测试结果进行t检验和相关分析。③结果术前SCL-90总分、躯体化、抑郁、焦虑、敌对、恐怖、偏执、精神病性因子得分高于常模 (t=-15.96、-2.60、44.32、39.72、-3.29、37.56、-2.01、2.21，P<0.05)，术后SCL-90总分、躯体化、强迫、人际敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性因子得分高于手术前(t=41.25、15.94、7.98、10.11、68.40、71.62、13.23、92.45、8.82、2.26，P<0.05)。甲状腺癌SCL-90总分、躯体化、强迫、人际敏感、抑郁、焦虑、敌对、恐怖、偏执因子得分手术后高于手术前(t=-35.32、-30.19、-10.38、-18.16、-14.22、-19.63、-19.08、-16.63、-21.65，P<0.01)。甲状腺癌男患者EPQ的精神质、神经质得分高于常模(t=35.94、45.40，P<0.001)，内外向得分低于常模(t=-7.17，P<0.001)，甲状腺癌女患者EPQ的精神质、神经质得分高于常模(t=38.25、41.87，P<0.001)，内外向得分低于常模(t=-10.27，P<0.001)。甲状腺癌患者内外向与SCL-90抑郁、焦虑和恐怖因子呈负相关(r=-0.38、-039、-0.37，P<0.01)，神经质与SCL-90总分、抑郁、焦虑和恐怖因子呈正相关(r=0.38、0.66、0.67、0.64，P<0.01)。④结论甲状腺癌患者手术前后心理健康问题明显，其与人格有关，人格缺陷可能促发甲状腺癌。

[关键词]甲状腺癌SCL-90人格心理健康

[中图分类号]R 395.6[文献标识码]A

【基金项目】唐山市科技计划项目(编号：13130262Z)。

【作者简介】陈允恩，男，本科，讲师。研究方向：临床精神病学。

Correlation relationship between preoperative and postoperative mental health status and personality of patients with thyroid cancerCHENYun,en,WANGChangqi,JIANGBaoshun,etal(CollegeofPsychology，NorthChinaUniversityofScienceandTechnology，Tangshan063000,China)

ABSTRACT[]ObjectiveTo investigate mental health status and personality of patients with thyroid cancer.The influence of personality on mental health and personality defect may be one of the factors of thyroid carcinoma.MethodsWe examined both the preoperative and postoperative mental state of 60 patients according to the symptom check list-90(SCL-90),and used the Eysenck Personality Questionnaire (EPQ) in the preoperative measurement,t test and correlation analysis to the result of the test.Results①The preoperative SCL-90 total scores,somatization,depression,anxiety,hostility,terror,paranoia,psychosis factor scores are higher in case group than control group(t=-15.96,-2.60,44.32,39.72,-3.29,37.56,-2.01,2.21,P<0.05),The postoperative SCL-90 total scores,somatization,compulsion,interpersonal sensitivity,depression,anxiety,hostile,terror,paranoid,psychosis factor scores are higher n case group than control group(t=41.25,15.94,7.98,10.11,68.40,71.62,13.23,92.45,8.82,2.26,P<0.05);②The SCL-90 total scores,somatization,compulsion,interpersonal sensitivity,depression,anxiety,hostility,terror,paranoia factor scorers in postoperative group are higher than preoperative group(t=-35.32,-30.19,-10.38,-18.16,-14.22,-19.63,-19.08,-16.63,-21.65,P<0.01);③The EPQ psychoticism and neurosis scores in male thyroid carcinoma patients are higher than control group(t=35.94,45.40,P<0.001),while that introversion and extroversion scores lower than control group (t=-7.17,P<0.001);The EPQ psychoticism and neurosis scores in female thyroid carcinoma patients are higher than control group (t=38.25,41.87,P<0.001),while that introversion and extroversion scores lower than control group (t=-10.27,P<0.001)；④Thyroid carcinoma patients' introversion and extroversion scores are negatively correlated with SCL-90 depression, anxiety and terror factor scores (r=-0.38,-039,-0.37,P<0.01),Thyroid carcinoma patients' neurosis are positively correlated with SCL-90 total scores,depression ,anxiety and terror factor scores(r=0.38,0.66,0.67,0.64,P<0.01).ConclusionThere are obvious psychological and personality problems with thyroid cancer patients before and after having operations. Psychological problems are related to personality. Personality defects may contribute to thyroid cancer.

[KEYWORDS]Thyroid cancer.Symptom check list-90.Personality.Mental health

甲状腺癌是头颈部和内分泌系统肿瘤中最常见的恶性肿瘤。每年甲状腺癌新发病例占所有癌症发病的1%～5%[1]。近30年来，甲状腺癌发病率持续快速增长，引起了人们的广泛关注[2]。甲状腺癌病因虽然目前仍不十分清楚，但已经有了不少研究认为甲状腺癌的发病受性别、年龄、国家地区、种族差异等因素影响。目前已知其病因包括：电离辐射、碘摄取异常、遗传和社会文化因素等[3]。随着社会的发展和医学模式的改变，人们对健康有了新的认识，希望在生理、心理和社会适应等方面都保持良好的状态。癌症及由此带来的各种心理问题，严重影响了癌症的转归，降低了患者的生活质量[4]。目前关于甲状腺癌的心理状况和心理干预研究开展也较快，而关于甲状腺癌发病与人格的关系研究很少，故以此为切入点探讨甲状腺癌患者的心理健康状况以及其发病与患者人格的关联，为治疗和预防甲状腺癌提供依据。……