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青少年双相情感障碍患者的家庭亲密度与适应性 特征及影响因素
杨光远景雅芹程燕敏李闻天
0
()
摘要:
目的 探讨青少年双相情感障碍患者的家庭亲密度与适应性特点及影响因素,为患者家 庭的临床治疗提供参考。方法 使用家庭亲密度与适应性量表(FACES)及家庭功能评定(FAD)量表评 估青少年双相情感障碍患者和健康青少年的家庭。家庭亲密度维度得分从低到高依次分为疏远、独 立、亲密及纠缠4 种不同形式,适应性维度得分从低到高依次分为僵化、结构、灵活及混乱4 种不同形 式。FAD 量表有7 个分量表,包括沟通、角色、问题解决、情感反应、情感卷入、行为控制和总功能,每 个分量表得分越低表明家庭在此维度上表现越健康。应用SPSS20.0 统计软件对患者家庭的亲密度、适 应性及家庭类型的影响因素进行多因素Logistics回归分析。结果 在亲密度方面,青少年双相情感障 碍患者家庭与健康青少年家庭在疏远、独立、亲密及纠缠的分布上差异具有统计学意义(Z=-3.42,P < 0.01),患者家庭的疏远程度与问题解决(OR=7.24,95%CI:1.79~29.67)及角色得分(OR=36.23,95%CI: 5.10~69.56)相关, 问题解决及角色得分越高,家庭疏远越严重。在适应性方面,患者家庭与普通家庭 在僵化、结构、灵活及混乱分布上差异具有统计学意义(Z=-4.36,P< 0.01),僵化程度与年龄(OR=1.36, 95%CI:1.09~1.69)、农村(OR=0.35,95%CI:0.14~0.85)、问题解决(OR=8.08,95%CI:1.73~37.71)、角 色(OR=58.56,95%CI:6.36~98.96)及行为控制(OR=0.15,95%CI:0.03~0.69)相关(均P < 0.05); 年龄 越大,问题解决及角色维度得分高的家庭较得分低的家庭更僵化;城市家庭较农村家庭僵化程度高,行 为控制得分高,家庭越倾向于混乱。在家庭类型方面,患者家庭与健康青少年家庭在极端型、中间型及 平衡型的分布上差异具有统计学意义(χ2=27.39,P< 0.01),患者极端型家庭与角色(OR=45.49,95%CI: 2.50~82.99)和情感介入(OR=0.11,95%CI:0.02~0.74)相关。结论 青少年双相情感障碍患者家庭的 亲密度受角色及问题解决影响,家庭适应性受年龄、农村、问题解决、角色及行为控制影响,在心理干预 中需考虑这些因素。
关键词:  青少年  双相情感障碍  亲密度  适应性
DOI:10.3969/j.issn.1009-6574.2020.11.009
基金项目:武汉市卫生健康委员会科研项目(WX19Y04)
Characteristics and influencing factors of family adaptability and cohesion in adolescents with bipolardisorder
Yang Guangyuan, Jing Yaqin, Cheng Yanmin, Li Wentian
()
Abstract:
Objective To explore the characteristics and influencing factors of family cohesion and adaptability of adolescent bipolar disorder patients, so as to provide reference for clinical treatment of patients with bipolar disorder. Methods The Family Adaptability and Cohesion Evaluation Scale( FACES) and the Family Assessment Device( FAD) were used to evaluate the adolescent patients with bipolar disorder and the ordinary adolescent families. The scores of family cohesion dimension were divided into alienation, independence, intimacy and entanglement from low to high, while the scores of adaptability dimension were divided into fossilization, structure, flexibility and confusion from low to high. FAD has seven subscales, including communication, role, problem solving, emotional response, emotional involvement, behavior control and total function. The lower the score of each subscale, the healthier the family is in this dimension. Multivariate logistic regression analysis was carried out to analyze the influencing factors of family cohesion, adaptability and family type by SPSS 20.0 statistical software. Rusults In terms of cohesion, the distribution of alienation, independence, intimacy and entanglement between patient families and healthy families was statistically significant( Z=-3.42,P < 0.01). The alienation of patient families was associated with problem solving( OR=7.24, 95%CI=1.79-29.67) and role score( OR=3.86, 95%CI=1.63-5.56). The severity of family alienation increases with the scores of problem solving and role. In terms of adaptability, the distribution of fossilization, structure, flexibility and confusion was statistically significant between patient families and healthy families( Z=-4.36,P<0.01). The fossilization of patient families was associated with age( OR=1.36,95% CI= 1.09-1.69), rural area( OR=0.35, 95%CI=1.96-0.16), problem solving( OR=8.08,95%CI=0.55-3.63), role (OR=58.56,95%CI=0.14-0.85) and behavioral control( OR=0.15,95%CI=0.03-0.69). The fossilization of family is more serious when they have higher age and higher scores in problem solving and role dimensions. Compared with rural families, urban families are more rigid and have higher scores of behavior control, and the more likely they are to be confused. In terms of family type, the distribution of extreme, intermediate and balanced type was statistically significant between patient families and ordinary families( χ2=27.39,P< 0.01). The polarization of patient families was associated with roles( OR=45.49, 95%CI=2.50-82.99) and emotional intervention( OR=0.11,95%CI=0.02-0.74). Conclusions The family cohesion of adolescents with bipolar disorder were affected by role and problem solving, and the adaptability were affected by age, region, problem solving, role and behavior control, which should be considered in psychological intervention.
Key words:  Adolescence  Bipolar disorder  Cohesion  Adaptability

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