| 李雨涵,宋方庆,王少霞,张学婷,王艳荣,方建群.强迫症患者心理痛苦与心身症状的关系：快感缺失的作用路径[J].四川精神卫生杂志,2025,(3):217-222.Li Yuhan,Song Fangqing,Wang Shaoxia,Zhang Xueting,Wang Yanrong,Fang Jianqun,Relationship between psychological distress and psychosomatic symptoms in obsessive-compulsive disorder patients： the mediating role of anhedonia[J].SICHUAN MENTAL HEALTH,2025,(3):217-222 |
| 强迫症患者心理痛苦与心身症状的关系：快感缺失的作用路径 |
| Relationship between psychological distress and psychosomatic symptoms in obsessive-compulsive disorder patients： the mediating role of anhedonia |
| 投稿时间：2025-01-03 |
| DOI：10.11886/scjsws20250103004 |
| 中文关键词: 强迫症 心身症状 快感缺失 心理痛苦 中介效应 |
| 英文关键词:Obsessive-compulsive disorder Psychosomatic symptom Anhedonia Psychological distress Mediating effect |
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| 中文摘要: |
| 背景 强迫症（OCD）是一种常见的精神疾病，被列为收入损失和生活质量下降的十大致残疾病之一。OCD患者心理痛苦是导致其快感缺失的重要原因，又与心身症状密切相关，探索快感缺失在心理痛苦与心身症状间之的作用路径对于完善OCD患者临床心理干预策略具有重要意义。目的 探讨快感缺失在OCD患者心理痛苦与心身症状之间的作用路径，以期为减少强迫症患者的心身症状提供参考。方法 选取2023年9月—2024年11月在宁夏医科大学总医院心理卫生中心门诊就诊的、符合《国际疾病分类（第10版）》（ICD-10）OCD诊断标准的90例患者为研究对象。采用快感缺失评定量表（DARS）、凯斯勒心理疾患量表（K10）、心身症状量表（PSSS）进行评定。采用SPSS 26.0插件Process 4.0中的模型4检验快感缺失在心理痛苦和心身症状间的作用路径，采用Bootstrap进行中介效应检验。结果 共84例患者（93.33%）完成本研究。OCD患者K10评分与PSSS总评分、心理维度评分以及躯体维度评分均呈正相关（r=0.559、0.460、0.551，P均<0.01）；K10评分和DARS总评分呈负相关（r=-0.527，P<0.01）；DARS总评分与PSSS总评分呈负相关（r=-0.497，P<0.01）。快感缺失是心理痛苦与心身症状间的作用路径，间接效应值为0.148（95% CI： 0.042~0.278），占总效应的26.48%。结论 OCD患者的心理痛苦可以直接影响其心身症状，也可以通过快感缺失间接影响心身症状。 |
| 英文摘要: |
| Background Obsessive-compulsive disorder （OCD） is a common neuropsychiatric illness and is listed as one of the top ten disabling conditions causing loss of income and reduced quality of life. Psychological distress is an important cause of anhedonia in OCD patients， and is closely related to psychosomatic symptoms. Therefore， exploring the role of anhedonia in the relationship between psychological distress and psychosomatic symptoms is of great significance for optimizing clinical psychological treatment protocols for OCD patients.Objective To explore the role of anhedonia in the relationship between psychological distress and psychosomatic symptoms in OCD patients， with the aim of providing references for managing psychosomatic symptoms in patients.Methods A total of 90 patients who met the diagnostic criteria for OCD according to the International Classification of Diseases， tenth edition （ICD-10）， and who visited the Mental Health Center outpatient clinic of General Hospital of Ningxia Medical University from September 2023 to November 2024 were selected as the study objects. The instruments and techniques used for the evaluation were： Dimensional Anhedonia Rating Scale （DARS）， 10-item Kessler Psychological Distress Scale （K10） and Psychosomatic Symptom Scale （PSSS）. Model 4 of the Process for SPSS 26.0 was used to test the mediating role of anhedonia in the relationship between psychological distress and psychosomatic symptoms， with Bootstrapping used to assess the significance of mediating effect.Results A total of 84 patients （93.33%） completed the valid questionnaire. K10 score was positively correlated with PSSS total score， psychological symptom score and physical symptom score （r=0.559， 0.460， 0.551， P<0.01）. K10 score was negatively correlated with DARS total score （r=-0.527， P<0.01）. The total score of DARS was negatively correlated with PSSS total score （r=-0.497， P<0.01）. Anhedonia mediated the relationship between psychological distress and psychosomatic symptoms， with an indirect effect value was 0.148 （95% CI： 0.042~0.278）， accounting for 26.48% of the total effect.Conclusion Psychological distress can affect the psychosomatic symptoms in OCD patients both directly and indirectly via anhedonia. |
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