躁鬱症狀心理病理因素與相關情緒能力之探討

由於躁鬱症患病人口比例高，死亡機率高，加上患者本身在處於躁期時病識感較差，這些因素使得躁鬱症已逐年受到社會上的重視。如何針對躁鬱症患者進行有效介入，一直是醫療上的重要議題，若能在藥物治療之餘，輔以心理治療加以介入，對於躁鬱症患者的預後會更有幫助。心理治療的介入方向，是針對心理病理因素加以治療，故探求精神疾患的心理病理因素，實為改善病況最基礎的研究方式，此外，情緒也是影響躁鬱症病程的重要因素之一。因此本研究希望，藉由躁鬱症心理病理因素與情緒能力的探討，來搭配相關醫療介入，俾使心理治療能有效率地進行。本研究透過比較40位躁鬱症患者、21位憂鬱患者與134位一般受試者其心理病理因素與情緒能力的表現，來評估三組之間的差異。結果顯示躁鬱組與一般組在對負向事件的永久性歸因、完美主義信念、自尊程度、增加正向情緒、失能調節、覺察負向情緒以及對負向情緒產生負向評價等七項因素上有所差異，除了對負向事件的永久性歸因與自尊程度外，其餘躁鬱組得分皆高於一般組；躁鬱組與憂鬱組則在增加正向情緒、覺察正向情緒、對正向情緒產生正向評價以及覺察負向情緒等四項因素上有所差異，躁鬱組在這四項因素的得分皆高於憂鬱組。

關鍵字

躁鬱症；心理病理因素；情緒能力

並列摘要

Bipolar disorder is being recognized gradually due to the high morbidity and mortality and poor insight during a manic episode of bipolar patients. In medical fields, it has been an important issue how to treat the bipolar patients effectively and efficiently. It would be better for prognosis of bipolar patients if we conduct psychological interventions combine with medication, hence, exploring the psychopathological factors which are the foundation to improve course and outcome. In addition, emotion also plays an important role to affect the course of bipolar disorder. Therefore, The aim of this study was to explore the psychopathological factors and emotional abilities of patients with bipolar disorder, and to combine medical treatment to enhance the efficiency of psychotherapy.Therefore, this study wished to enable the psychotherapy effectively by means of exploring the psychopathological factors and emotional abilities of bipolar disorder, and combining with medical treatment. T his study evaluated variation between three groups by means of comparing with their performance of psychopathological factors and emotional abilities, three groups contain 40 bipolar patients, 21 depressive patients and 134 normal control participants. The result demonstrated that there were seven factors that have a significant difference between bipolar group and control group, and these factors contain : Permanent attribution of negative events, Perfectionism, Self-esteem, Increasing positive affections, Non-adaptable regulation, Awareness of negative affections, Negative appraisal of negative affections, in addition to Permanent attribution of negative events and Self-esteem, scores of other factors in bipolar group were significantly higher than control group. There were four factors that have a significant difference between bipolar group and depression group, and these factors contain : Increasing positive affections, Awareness of positive affections, Awareness of negative affections, Positive appraisal of positive affections, scores of four factors in bipolar group were significantly higher than depression group. This study also use multiple regression analysis to predict the effect of psychopathological factors and emotional abilities on manic and depressive symptoms, and use structural equation modeling to assess the goodness-of-fit. The result indicated that factors affecting depressive symptoms contain: Permanent attribution of positive events、Perfectionism、Self-esteem、Circadian rhythms、Non-adaptable regulation；factors affecting manic symptoms contain: Self-esteem、Increasing positive affections、Positive appraisal of positive affections. In conclusion, significant differences were indeed observed on psychopathological factors and emotional abilities between three groups, and psychopathological factors and emotional intelligence also affect manic and depressive symptoms significantly. Psychopathological factors and emotional abilities discovered in this study provide important guidance and direction for further research of pathology and treatment of bipolar disorder.