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用疾病自评量表(SCL一90),对7l例不同性别、年龄、文化程度、病期、畸残度及有无近亲的麻风病人进行了心理分析,表明麻风病人的总痛苦水平较高,心理反应的总均分为105.549±57.214,SCL—90 lO个月因子水平平均超过2分的都大于5%,较正常人高。畸残程度对病人心理有直接影响,Ⅱ~Ⅲ级畸残病人的SCL—90各因子分较I级畸残者显著增高。无近亲和院内隔离的病人,强迫、抑郁、恐怖性焦虑、偏执观念和精神病的均分,比有近亲和院外治疗者高。病期与SCL—90总分高度相关,病期越长,病人的失落感、恐怖感和敌意感越重。文盲患者的抑郁和恐怖性焦虑,较有小学以上文化者的严重。不同性别、年龄间的SCL—90分无明显差异。分析71例麻风的SCL—90各因子发现,10个因子之间有显著差别,其中最敏感的为人际敏感、抑郁和恐怖性焦虑,较为敏感的为强迫、焦虑和敌意.作者从与病人交谈中了解到,从常人进入麻风病人的角色后,心理反应首先是恐怖性焦虑和躯体化症状,然后是强迫、人际敏感和偏执等症,个别病人变得酗酒、迷信、赌博、有敌意或欲自杀。71例中有过自杀念头的48例(68.6%),有过自杀行为者4例。作者认为,处理麻风病人的心理问题,关键在于:1、争取社会支持,改善治疗环境;2、加强健康教育,消除社会对麻风的恐惧;3、医护人员多与病人交谈,劝慰他们,使其心理达到领悟,消除恐惧和心理障碍;4、早发现、早治疗,预防和减少畸残,以保障病人身心健康。
A psychosocial analysis of 7l leprosy patients with different gender, age, educational level, duration of disease, degree of malocclusion, and with or without close relatives was conducted using the SCL-90 scale, indicating that the total level of pain in leprosy patients was high , The total mean score of psychological reaction was 105.549 ± 57.214, SCL-90 lO months average level of factors over 2 points were greater than 5%, higher than normal. The level of malnutrition has a direct impact on the patient’s psychology. The SCL-90 scores of patients with grade Ⅱ ~ Ⅲ malocclusion are significantly higher than those of level I malnutrition. No relatives and in-hospital isolation of patients, coercion, depression, panic anxiety, paranoid ideation and mental illness were higher than those with close relatives and hospital treatment. The duration of illness was highly correlated with the overall score of SCL-90. The longer the disease, the heavier the patient’s feelings of loss, terror and hostility. Depression and panic-related anxiety among illiterate patients are more serious than those with primary education or above. There was no significant difference in SCL-90 between different genders and ages. Analysis of 71 leprosy SCL-90 factors found significant differences between the 10 factors, the most sensitive of interpersonal sensitivity, depression and panic anxiety, the more sensitive to coercion, anxiety and hostility. Learned that, after entering the leprosy role from ordinary people, the psychological reaction is first of all the horrible anxiety and somatization symptoms, followed by compulsion, interpersonal sensitivity and paranoid embolism. Individual patients become alcoholic, superstitious, gambling, hostile or wanting suicide. Among the 71 cases, 48 (68.6%) had suicidal thoughts and 4 had suicide behaviors. The author believes that the key to tackling the psychological problems of people with leprosy lies in: 1. striving for social support and improving the treatment environment; 2. strengthening health education to eliminate the fear of leprosy in society; 3. talking to patients more often by health care workers to comfort them and make them Psychology to achieve insight, to eliminate fear and psychological disorders; 4, early detection, early treatment, prevention and reduction of disability to protect the patient’s physical and mental health.