MALE AND FEMALE CHRONIC PAIN PATIENTS CATEGORIZED BY DSM-III PSYCHIATRIC DIAGNOSTIC-CRITERIA
MALE AND FEMALE CHRONIC PAIN PATIENTS CATEGORIZED BY DSM-III PSYCHIATRIC DIAGNOSTIC-CRITERIA
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DOI：
10.1016/0304-3959(86)90074-6
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发表时间：
1986-08-01
期刊：
影响因子：
7.4
通讯作者：
ROSOMOFF, H
中科院分区：
文献类型：
--
作者：
FISHBAIN, DA;GOLDBERG, M;ROSOMOFF, H
283例慢性疼痛患者，连续入住迈阿密大学医学院综合疼痛中心，接受了基于美国精神病学协会精神疾病诊断和统计手册（DSM-III）标准和流程图的广泛精神病学评估。所有患者均接受以下类型的诊断：DSM-III轴I; DSM-III轴II和人格类型。对整个患者样本的指定诊断分布进行了审查，并对男性和女性患者的每种诊断的患病率进行了统计学比较。各种诊断类型的焦虑综合征和抑郁症是最常见的轴I诊断，超过一半的患者样本接受这些诊断中的每一个。男性在轴I诊断的间歇性爆发性障碍、工作抑制性适应障碍、酗酒和其他药物依赖中所占比例明显偏高，而女性在各种诊断类型的当前抑郁症和躯体化障碍中所占比例明显偏高。58.4%的患者符合轴II人格障碍诊断标准。患者组中最常见的人格障碍是依赖型（17.4%）、被动攻击型（14.9%）和表演型（11.7%）。男性在偏执和自恋障碍中的比例明显过高，而女性在表演障碍中的比例过高。患者组中最常见的人格类型是强迫型（24.5%）和依赖型（10.6%）。所有的性格类型在两性之间的分布都是相似的。本研究的结果进行了比较，以前的研究DSM-III诊断慢性疼痛患者，并讨论了在一般人群中的DSM-III诊断的患病率。提出了一些问题，如某些DSM-III诊断在慢性疼痛人群中的适用性。
Two hundred and eighty-three chronic pain patients, consecutive admissions to the Comprehensive Pain Center of the University of Miami School of Medicine, received an extensive psychiatric evaluation based upon the American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria and flowsheets. All patients received the following type of diagnoses: DSM-III axis I; DSM-III axis II, and personality type. The distribution of assigned diagnoses for the entire patient sample was reviewed and a statistical comparison between male and female patients was performed with regards to the prevalence of each diagnosis. Anxiety syndromes and depression of various diagnostic types were the most frequently assigned axis I diagnoses with over half the patient sample receiving each of these diagnoses. Males were significantly overrepresented in the axis I diagnoses of intermittent explosive disorders, adjustment disorders with work inhibitions, and alcohol abuse and other drug dependence, while females were significantly overrepresented in disorders of current depression of various diagnostic types and somatization disorders. 58.4% of the patients fulfilled criteria for axis II personality disorder diagnoses. The most frequently personality disorders found in the patient group were dependent (17.4%), passive aggressive (14.9%), and histrionic (11.7%). Males were significantly overrepresented in paranoid and narcissistic disorders while females were overrepresented in histrionic disorder. The most frequent personality types found in the patient group were compulsive (24.5%) and dependent (10.6%). All personality types were similarly distributed between the sexes. The results of the present study were compared to a previous study of DSM-III diagnoses in chronic pain patients and are discussed in terms of the prevalence of DSM-III diagnoses in the general population. Questions are raised as to the applicability of certain DSM-III diagnoses in the chronic pain population.