探討強迫症患者之焦慮、憂鬱症狀與自殺意念之相關

Anxiety, Depressive Symptom and Suicide Ideation of Outpatients with Obsessive Compulsive Disorders

洪子棋(Tzu-Chi Hung)

指導教授 ： 張秀如

共同指導教授 ： 邱震寰 ； 陳映燁

臺北醫學大學/護理學院/護理學研究所/碩士(2008年)

摘要

強迫症是一種相當常見的慢性焦慮性疾患，患者經常因為強迫症狀嚴重影響日常生活，繼而引發焦慮、憂鬱之情緒，甚而進一步產生自殺意念。自殺意念為自殺企圖、自殺行為之前趨因素，故臨床上不能忽視此議題之重要性。近幾年來強迫症相關之研究越來越多，但是對於患者強迫症狀與焦慮、憂鬱症狀及自殺意念間之關係卻很少同時被探討，本研究主要目的為瞭解強迫症患者：1.高強迫症狀組與低強迫症狀組之人口學差異。2.高強迫症狀組與低強迫症狀組在主要研究變項差異。3.自殺意念預測因素。
本研究採描述性研究法，研究樣本為128位臺北市某區域教學醫院門診強迫症患者，研究工具包括：1.個人基本資料表2.貝克焦慮量表（Beck Anxiety Inventory; BAI）3.貝克憂鬱量表（Beck Depression Inventory II; BDI-II ）4. 耶魯－布朗強迫症量表(Yale－Brown Obsessive Compulsive Scale; Y-BOCS) 5. 貝克自殺意念量表(Beck Scale for Suicide Ideatio; BSS)。本研究依照樣本所得Y-BOCS得分分為兩個群體，分數大於15分者，為高強迫症狀組; 分數小於或等於15分者，為低強迫症狀組。所得資料以描述性及推論性統計進行分析，以皮爾森相關積差了解強迫症狀與焦慮、憂鬱症狀及自殺意念彼此間之關係，並以複迴歸(Multiple regression)探討焦慮、憂鬱及強迫症狀對自殺意念的影響。
研究結果發現門診強迫症患者中:1.高強迫症狀組中，未婚者人數明顯比低強迫症狀組多，即未婚者強迫症狀比已婚者嚴重。2.高強迫症狀組中，初罹病年齡越輕者比低強迫症狀組多，即越早發病者強迫症狀越嚴重。3.高強迫症狀組患者之強迫症狀、焦慮、憂鬱症狀、自殺意念得分明顯高於低強迫症狀組4.強迫症患者自殺意念之預測因子為焦慮及憂鬱程度。研究結果可提供精神衛生護理專業人員，護理強迫症個案時，評估及預防自殺危險性之參考。
關鍵詞：強迫症、焦慮症狀、憂鬱症狀、自殺意念。

關鍵字

強迫症 ； 焦慮症狀 ； 憂鬱症狀 ； 自殺意念

並列摘要

Obsessive-compulsive disorder (OCD) is a common chronic anxiety disorder, which often significantly affects patients’ daily life. Patients with OCD often accompany with anxiety, depression and even suicide ideation. Since suicide ideation is the preceding factor of further suicide attempt, the importance of the issue cannot be ignored. However, there have been very few studies to explore the relationship among anxiety, depressive symptoms and suicide ideation for patients with obsessive-compulsive disorders. The main purposes of this study are to explore 1.the demographic differences between high obsessive-compulsive symptoms and low obsessive-compulsive symptoms for patients with OCD; 2.the differences in the major study variables between patients with high obsessive-compulsive symptoms and low obsessive-compulsive symptoms for patients with OCD; 3.predictors of suicide idea for patients with OCD.
This study employed a descriptive cross-sectional research design. A sample of 128 patients with OCD was recruited from the outpatients of a medical teaching hospital in northern Taiwan. The research instruments include: 1.Demographic characteristics questionnaire; 2.Beck Anxiety Inventory (BAI), 3.Beck Depression Inventory II (BDI-II ), 4.Yale－Brown Obsessive Compulsive Scale (Y-BOCS), 5.Beck Scale for Suicide Ideatio (BSS). In this study we divided patients into two groups. Patients with Y-BOCS score higher than 15 is in high obsessive-compulsive symptoms group, Patients with Y-BOCS score lower than and equal to 15 is in low obsessive-compulsive symptoms group. Statistics methods include descriptive statistics, Pearson's product-moment correlation, independent samples t-test, chi-square test, and multiple regressions.
The results revealed that patients with high Y-BOCS scores were at a higher rate of being with single marital status, earlier onset age, as well as higher levels of anxiety, depressive symptoms, and suicide ideation. The predictors of suicide ideation were anxiety and depressive symptoms. Results from this study can provide important implications to psychiatric mental health nurses for assessing and preventing suicide risk for outpatients with OCD.

並列關鍵字

obsessive-compulsive disorder ； anxiety ； depressive symptoms ； suicidal ideation

參考文獻

吳美玲（2003）•大專學生自我知覺的親子關係與人格特質對自殺意念的影響．未發表的碩士論文•中原大學•中壢。

林曉芳（2004）•認知取向技術在焦慮兒童與青少年之治療•輔導季刊，40（1），48-55。

林清華、徐秋蓬、劉明德（2003）•焦慮症之藥物治療•基層醫學， 18（2），30-38。

何志培（2000）•如何走出強迫症的陰霾•咨商與輔導，172，15-18。

陳柏妤、游書涵、黃鈞蔚、陳映燁、陳喬琪、李明濱（2005）•從生理、心理與社會層面檢視自殺行為的理論•北市醫學雜誌，2（8），1-11。