The Study Of Life Events,Trait Coping Style And Type A Behavior Character In Patients With Factitious Urticaria

Objective: Factitious urticaria namely dermatographism, the definition of which is liner-wheal appears in the skin with itch and subsidises soon after it has been scored with blunt-tipped object. Factitious urticaria has some characteristics as following : it appears mostly in young adults with longer course; it was prone to attacking repeatedly; the period of treatment is long; the curative effect is not very good; it effects patients'life quality badly. The objective of this study is to discuss the relations between factitious urticaria and psychological factors in patients with factitious urticaria through investigating life event scale,trait coping style questionnaire and the type A behavior rating scale.Methods: The case group involved 76 typical factitious urticaria patients who were outpatients in the department of dermatology of the second hospital, Hebei Medical University, from January, 2006 to December, 2006. The control groups involved 32 patients with dermatosis with superficial fungus infection and 60 healthy persons. The case group was compared with the two-control groups in the life event scale,trait coping style questionnaire and the type A behavior rating scale.The case group and the control groups were strictly selected according to the diagnoses standards. The case group must conform to the following standards: 1. The patients who were outpatients in the department of dermatology of second hospital, Hebei Medical University, from January, 2006 to December, 2006; 2. All cases conformed to diagnostic criteria of the factitious urticaria; 3.The education level must be above primariy school level; 4.There were no blood relationships among or between the members in case group and the two-control groups; 5.Factitious urticaria patients with other dermatosises, chronic disease in body and spirit disease were not included in the case group. At the same time, 32 patients with superficial fungus disease (tinea manus or tinea pedis) proved by microscopic examination and 60 healthy persons were took as the control groups. The standards for the control groups as following: 1.The two-control groups matched the case group in gender, age, occupation, education level and so on. 2. There were no blood relationships among or between the members in two-control groups; 3. Peoples with other dermatosises, chronic disease in body and spirit disease were not included in the control groups. The investigation content included: 1. ordinary circumstances: gender, age, occupation, education level, address and medical data including complaint, course of diseases and suffered from other diseases whether or not. 2. The three groups were surveyed by using the life event scale (LES) compiled by Yang De-sen and Zhang Ya-lin, trait coping style questionnaire (TCSQ) and the type A behavior rating scale fits Chinese compiled chiefly by Zhang Bo-yuan. The case group and the control groups were investigated by the same specialist with the uniform guiding words. The testees were requested to complete the scale on one's own. Then the three group's investigation results were calculated, compared and analysed. The investigation data were put into EXCEL tabulation in computer and analysed by means of statistical methods as one-way ANOVA, SNK-q-text, t-test, linear correlation text and X2-test. The statistics results were expressed by average±standard deviation( x±s).Results:1 Investigation results of life event scale1.1 The positive life events stimulus quantity average score in one year in the case group were 1.03±2.88, then they were 0.91±2.74, 1.02±3.31 in the superficial fungus disease patients and the healthy persons respectively. The three groups'data were compared with each other and showed no statistical difference (P>0.05). The negative life events stimulus quantity average score and the total stimulus quantity average score in one year were 12.16±15.11 and 13.21±15.32 in the case group respectively, they were higher than those of the superficial fungus disease patients group (5.03±7.42 and 5.94±7.54) and the healthy persons group (5.07±9.33 ang 6.08±9.42).The differences showed statistical significance (P<0.05).1.2 The positive life events stimulus quantity average score in one year was 1.03±3.03 in male patients group. It was 1.02±2.80 in female patients group. These two groups'data were compared with each other and showed no statistical difference (P>0.05). The negative life events stimulus quantity average score and the total stimulus quantity average score in one year were 7.40±11.72 and 8.42±11.85 in male patients group respectively. They were lower than those of female patients group (15.81±16.48 and 16.88±16.75). The difference showed statistical significance (P<0.05).1.3 The common negative life events in the case group were in following order : great change of living pattern (bad sleep) ( 25%,19/76 cases); heavy pressures in work and study (14.47%,11/76 cases); misunderstanding by others(13.16%,10/76 cases); bad relations between parents, family financial straits and in debt over 500 yuan (acount for 11.84% and 9/76 cases equally); family members were suffered from serious illness or severes trauma(10.53%,8/76 cases); bad relations with lover's parents and bad emotion between husband and wife (acount for 9.21% and 7/76 cases equally ).2 Investigation results of trait coping style questionnaire2.1 The positive coping style average score in the case group was 31.29±6.35. It was lower than those of the superficial fungus disease patients(35.38±6.44) and the healthy persons(34.75±6.18). The differences showed statistical significance (P<0.05). The negative coping style average score in the case group was 30.30±6.88. It was higher than those of the superficial fungus disease patients (23.16±5.18) and the healthy persons (23.27±5.80). The differences showed statistical significance (P<0.05). The negative coping style average score and the negative life events stimulus quantity average score in the case group took on positive linear correlation and the correlation coefficient (r) amount to 0.369. It showed statistical significance (P<0.05).2.2 The positive coping style average score in male patient group was 32.49±5.91. It was 30.37±6.59 in female patient group. The two groups'data were compared with each other and showed no statistical difference (P>0.05). The negative coping style average score in female group was 28.64±6.11. It was lower than that of the case group of female. The difference showed statistical significance (P<0.05).3 Investigation results of the type A behavior rating scale3.1 Time hurry average score, competitive, hostility average score and the total average score were 14.08±4.28, 14.08±4.38 and 28.16±7.65 respectively in the case group. They were all higher than those of the superficial fungus disease patients (11.16±3.90, 12.59±3.90 and 24.06±6.60) and the healthy persons (11.9±3.98, 12±3.24 and 23.92±6.09). The differences showed statistical significance (P<0.05).3.2 Persons taking on type A behavior character and type midst leaning toward A behavior character in the case group was account for 19.74% and 31.58% respectively. They were higher than those of the superficial fungus disease patients(6.25%,18.75%) and the healthy persons (5%, 13.33%). The differences showed statistical significance (P<0.0125). Persons taking on type extreme midst behavior character and type B behavior character in the case group was account for 40.79% and 7.89% respectively. They were lower than those of the superficial fungus disease patients(56.25%,18.75%)and the healthy persons(65%,16.67%). The differences showed statistical significance (P<0.0125).Conclusion: 1 The negative life events stimulus quantity average score and the total stimulus quantity average score in one year in the case group were higher than those of the superficial fungus disease patients and the healthy persons, which suggested that the factitious urticaria patients endured greater spiritual pressure and they were in a higher psychological and societal stress level condition. The higher psychological and societal stress level that factitious urticaria patients in were likely to have something to do with this disease. Moreover, the negative life events stimulus quantity average score and total stimulus quantity average score in one year in female patient group were higher than those of male patient group, which suggested that female patients were in a higher psychological and societal stress level than male patients.2 The negative coping style average score in the case group were higher than those of the superficial fungus disease patients and the the healthy persons, which suggested that the factitious urticaria patients more tended to using negative coping style than the two control groups of persons. Moreover, the negative coping style average score of the female factitious urticaria patients were higher than that of the male factitious urticaria patients, which suggested that the female factitious urticaria patients more tended to using negative coping style than the male factitious urticaria patients.3 The negative coping style average score and the negative life events average score in the factitious urticaria patients took on positive linear correlation, which suggested that the condition of higher psychological stress level that the factitious urticaria patients in had something to do with their negative coping style and took on positive linear correlation.4 The proportion of type A behavior character and type midst leaning toward A behavior character in the case group were higher than those of the superficial fungus disease patients and the healthy persons. Persons taking on type extreme midst behavior character and type B behavior character in the case group occupied smaller proportion comparing with the two control groups, which suggested that type A behavior character and type midst leaning toward A behavior character were likely to have something to do with this disease.5 On the base of type A behavior character and type midst leaning toward A behavior character, patients with factitious urticaria obtained more negative life events stimulus. Moreover, they took on negative coping style in response. This chain-like psychic characteristic may have a certain relation with this disease.