The Role of Disease-prone personalities in the Onset of Colorectal Cancer : A Case-control Study

背景：虽然人格因素，尤其是情绪压抑和失去希望与癌症的发生和发展有关，但关于这些因素在结直肠癌发展中的具体作用的报道很少。还有人声称，以夸张的情感表达、自我中心和矛盾的联系为特征的“歇斯底里”人格可能有助于预防癌症。这项以社区为基础的病例对照研究调查了与情绪压抑或失去希望相关的人格因素是否与结直肠癌风险增加有关，以及与歇斯底里人格相关的因素是否与风险降低有关。方法：在日本福冈地区随机抽取497例新诊断的结直肠癌患者和809名对照患者，采用压力量表（SI）进行自我管理问卷，评估日本人可能的疾病易感性和其他相关人格。结果：采用logistic回归模型控制年龄、性别和居住地后，与情绪抑制（“未满足的接受需求”、“利他主义”和“合理化冲突/挫折”）或失去无望（“低控制感”、“客体依赖/损失”和“客体依赖/幸福”）相关的SI量表与结直肠癌无关。另一方面，两个代表歇斯底里人格要素的量表，“对象依赖/矛盾心理”和“利己主义”，与风险有着保护性的联系。额外调整身体质量指数和生活方式因素并没有实质性地改变这些关联。结论：在日本人群中，虽然与情绪压抑或失去希望相关的性格可能不是结直肠癌的危险因素，但矛盾关系和自我中心可能具有保护作用。

Background : Although personality factors, especially emotional suppression and loss-hopelessness, have been linked to the occurrence and progression of cancer, little is reported about the role of these factors on the development of colorectal cancer specifically. It has also been claimed that a "hysterical" personality characterized by exaggerated emotional expressions, egocentricity, and ambivalent connection may be protective from cancer. This community-based case-control study examined if personality factors relevant to emotional suppression or loss-hopelessness are associated with an increased risk of colorectal cancer, and if factors related to the hysterical personality are associated with a decreased risk.Methods : The stress inventory (SI), a self-administered questionnaire developed to assess possible disease-prone and other relevant personalities in Japanese, was completed by 497 patients with newly diagnosed colorectal cancer and 809 controls randomly selected in the Fukuoka area of Japan.Results : After controlling for age, sex, and are of residence using a logistic regression model, none of the SI scales relevant to emotional suppression ("unfulfilled needs for acceptance", "altruism" and "rationalizing conflicts/frustrations") or loss-hopelessness ("low sense of control", "object dependence/loss" and "object dependence/happiness") was associated with colorectal cancer. On the other hand, two scales representing elements of the hysterical personality, "object dependence/ambivalence" and "egoism", were protectively associated with risk. Additional adjustment for body-mass index and lifestyle factors did not materially change these associations.Conclusions : While personalities relevant to emotional suppression or loss-hopelessness may not be a risk factor for colorectal cancer in the Japanese population, ambivalent connection and egocentricity may be protective.