|
艾滋病恐惧症需要“社会学治疗”
2011-04-11 15:04:20 来源: 新民晚报(上海) 首席记者 施捷
“随着HIV感染的流行率及发病率逐年上升，越来越多的心理问题开始出现，其中艾滋病恐惧症是主要心理问题之一。”关于被描绘得有形有状的所谓阴性艾滋病，上海市公共卫生临床中心副主任、市艾滋病诊疗中心主任卢洪洲的答复开门见山。
国外首先报道
艾滋病恐惧症，就是对艾滋病的恐惧及伴随恐惧产生的各种生理和心理的不适症状。其最早于上世纪80年代由国外首先报道，但迄今为止，国内外学者尚没有对此临床现象给出一个统一的定义。卢洪洲说，目前国际上较常用且受到普遍认可的是“the worried well of AIDS”，指那些反复多次接受血清检测和临床评估，虽结果呈阴性，但却一直坚信自己具有与引发艾滋病的病源HIV相关的感染症状的个体。
与此同时，我国有关精神障碍分类与诊断标准，则给“艾滋病恐惧症”作了如下定义：它是一种混合性神经症，核心症状可表现为焦虑、疑病、恐惧、强迫、抑郁症状中的某一种或几种，也可同时伴有与艾滋病的临床症状相类似的躯体症状。疾病具有一定的人格基础；起病常受高危行为历史以及生活压力事件的影响；HIV相关检测结果为阴性；患者内心痛苦，反复求医。
性格胆小多疑
艾滋病恐惧症的“病因”若从心理学角度来分析，不仅仅是由于患者对艾滋病的临床表现和传播途径的片面性认识和错误理解。卢洪洲教授进一步解释说，这些人中的相当一部分，发病与其本身的性格基础以及其他心理障碍有密切关系，与焦虑障碍关系尤为密切。艾滋病恐惧症患者有相当一部分既往有冶游史，可能存在不安全性行为，心理上通常有罪恶感或毁灭感，并有惩罚自己所犯罪行的愿望；也有一部分无高危行为的人，恐惧完全出自自己的主观想象和联想。艾滋病恐惧症患者一般都有一定的人格基础性格多偏向于幼稚、胆小、内向、害羞、多疑，先前可能曾出现过类似的对其他疾病的担忧。
“当然，有些艾滋病恐惧症患者会出现类似急性HIV感染期症状，如低热、纳差、乏力、盗汗等，但大多数患者并没有这些症状。”卢洪洲指出，根据不同症状，艾滋病恐惧症可归纳为焦虑型、恐惧型、强迫型、疑病型4种类型。有人临床表现为想到或看到“艾滋病”3个字及艾滋病的相关报道即出现紧张不安和烦躁；有人对艾滋病及其与艾滋病有关的一切东西和场所都特别恐惧，比如知道艾滋病病毒可以通过血液传播，于是对血液表现出极度的恐惧；强迫型艾滋病恐惧症比较常见，患者通常表现为担心自己会被传染，处处过分小心谨慎，极力回避各种可能被感染的场合；最为多见的是疑病型，患者坚持认为自己已经感染了艾滋病病毒，因此反复检查，四处求医，经多次检查，结果为阴性，却仍不能消除自己的恐惧和担心。被确诊的患者病程一般会超过2个月。
加强知识普及
艾滋病恐惧症是否需要治疗？如何治疗？卢洪洲认为不仅“需要治疗”，而且放在首要位置的，应该是“社会学治疗”，即通过加强艾滋病知识的宣传普及，让公众了解艾滋病的传播方式，“在让大家了解哪些情况易感染艾滋病的同时，明确告诉公众哪些情况下不可能感染艾滋病。”
至于艾滋病恐惧症的医学治疗，有药物治疗（如焦虑、恐惧、抑郁等症状影响到患者的日常生活、学习、工作时，要考虑使用抗焦虑药物）和心理治疗两个方面。对艾滋病恐惧症患者进行心理治疗是比较有效的方法，具体干预策略包括评估患者艾滋病的相关知识水平，与患者讨论性行为史、药物注射史以及输血史，改变患者错误认知，帮助患者应对那些引发担忧以及强迫行为的情境，训练患者对身体状况实施自我监控等等。大多数艾滋病恐惧症患者的预后都比较好。
艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复
 |
| 图示∶2010年12月即将出版的《中国特色医疗金鉴》登载的刘君主任及其机构 |
| |
|
|
AIDS phobia need to "sociological treatment"
2011-04-11 15:04:20 Source: Xinmin Evening News (Shanghai) Shi Jie, chief reporter
"With the prevalence of HIV infection and the incidence increased year by year, more and more psychological problems began to emerge, which fear of AIDS is one of the major psychological problems." Visible has been described on the so-called negative-like AIDS, Shanghai Deputy Director of Public Health Clinical Center, the city-Zhou Lu, director of AIDS treatment center answer straight to the point.
First reported foreign
AIDS phobia is the fear of AIDS and with fear for a variety of physical and psychological symptoms. The first 80 years in the last century was first reported by the foreign, but so far, domestic and foreign scholars to this clinical phenomenon yet to give a unified definition. Hong-Zhou Lu said that currently more commonly used internationally, and has been generally recognized that "the worried well of AIDS", refers to those receiving repeated testing and clinical evaluation of serum, although the results were negative, but has been convinced that he has the pathogen that causes AIDS symptoms of HIV infection related to the individual.
At the same time, China's relevant classification and diagnostic criteria for mental disorders, then to the "AIDS phobia" made the following definition: it is a mixed neurosis, can be expressed as the core symptoms of anxiety, hypochondriasis, fear, compulsion, depression symptoms in one or a few, can also be accompanied by clinical symptoms of AIDS are similar to the physical symptoms. The basis of certain personality disorders; onset of the frequent high-risk behavior and history of the impact of stressful life events; HIV-related test results were negative; patients with heart pain, repeatedly seek medical attention.
Timid and suspicious character
AIDS phobia "causes" From a psychological perspective, not only because of the clinical manifestation of AIDS patients and the transmission of knowledge and wrong interpretation of the one-sidedness. Professor Lu Hongzhou further explained that a considerable portion of these people, the incidence based on its own personality and other psychological disorders are closely related, and anxiety disorder and Malaysia. Fear of AIDS patients have a considerable portion of the rule of previous travel history, there may be unsafe sex, usually psychological sense of guilt or destroyed, and punishment of crimes committed by their own desire; also part of the no-risk acts, completely out of fear own subjective imagination and association. Fear of AIDS patients have certain personality based on the general character and more biased in favor of naive, timid, introverted, shy, suspicious, may have appeared previously on similar concerns about other diseases.
"Of course, some of the fear of AIDS patients appears similar to acute HIV infection symptoms, such as fever, anorexia, fatigue, night sweats, etc., but most patients do not have these symptoms." Zhou Lu pointed out that, according to different symptoms, AIDS phobia can be summarized is anxious and fearful, compulsive, hypochondriasis type 4 types. Some clinical manifestations of thought or see "AIDS" 3 words and AIDS-related reports that appeared nervous and irritable; someone with AIDS and AIDS-related things and places are all the special fears, such as that by the blood of HIV spread, so the blood showed extreme fear; compulsive fear of AIDS are more common, patients usually presents about being contagious, always too cautious, tried to evade the possible infection of the occasion; the most common is the suspect disease type, patients insist that they are infected with the AIDS virus, so again check around the doctor, after repeated checks, the result is negative, still can not eliminate their fears and concerns. The general course of the disease was diagnosed in patients with more than 2 months.
Enhance literacy
The need for treatment of AIDS phobia? How is it treated? Hong-Zhou Lu that not only "need treatment", and the most important position, and should be "sociological treatment", that is by strengthening the popularization of knowledge of AIDS, so that way the public about the spread of AIDS, "the situation in which everyone is easy to understand AIDS at the same time, clearly can not tell the public the circumstances under which HIV infection. "
As for the medical treatment of AIDS phobia, and drug treatment (such as anxiety, fear, depression and other symptoms of the patient's daily life, study, work, to consider the use of anti-anxiety medication) and psychotherapy are two aspects. Fear of AIDS patients for psychological treatment is more effective way, specific intervention strategies including the assessment of patients with AIDS-related knowledge, to discuss sexual history with the patient, history of drug injection and blood transfusion history and change the wrong perception of patients and help patients deal with those raised concerns about the situation and the compulsive behavior, training, implementation of patient self-monitoring of physical condition and so on. Most of the prognosis of patients with AIDS phobia are better.
|
