以头晕为主诉的无症状脑梗死患者躯体化症状自评量表的临床应用

摘要

Objective To assess the mental state of silent brain infarction (SBI) patients with complaints of dizziness,and to explore the value of self-rating somatic symptom scale (SSS) in the diagnosis of mental disorders in SBI patients with complaints of dizziness.Methods The mental states of SBI patients with complaints of dizziness in Outpatient of Shanghai TCM-Integrated Hospital,Shanghai University of Traditional Chinese Medicine from June 2013 to January 2015 were assessed by using SSS,SAS and SDS.SAS 9.2 statistical software was used to test SSS retest reliability and Cronbach alpha correlation analysis,and the area under ROC curve was calculated.Results There were 65.4％ of patients with mental disorder by SSS.The retest reliability of SSS was 0.864,Cronbach α was 0.841.The correlation coefficients of SSS-SAS,SSS-SDS,SAS-SDS was 0.826,0.837,0.840 respectively.The correlation coefficient of each factor score and total score in SSS was ranged from 0.792-0.861.When SSS coarse fraction was greater than 36,Youden index was the largest,sensitivity was 86.7％,specificity was 70.0％,the area under ROC curve was 0.856.Conclusion SBI patients with complaints of dizziness have a high psychological barrier.SSS has good reliability and validity,it can be used to help neurological physicians to identify patients with dizziness as the chief complaint of SBI patients with psychological disorders.%目的 了解以头晕为主诉的无症状脑梗死(SBI)患者的心理状态,并探讨躯体化症状自评量表(SSS)在以头晕为主诉的SBI患者心理障碍识别中的价值.方法 采用SSS与焦虑自评量表(SAS)和抑郁自评量表(SDS)对2013年6月～2015年1月于上海中医药大学附属上海市中西医结合医院门诊就诊的以头晕为主诉的SBI患者的心理状态进行评定.采用SAS 9.2统计软件,对SSS进行重测信度和Cronbach α相关分析,并计算ROC曲线下面积.结果 通过SSS评定,有65.4％的患者存在心理障碍;SSS的重测信度为0.864,Cronbachα为0.841,SSS-SAS、SSS-SDS、SAS-SDS相关系数分别为0.826、0.837、0.840.SSS各因子分与SSS总分的相关系数0.792～0.861.SSS粗分＞36分为界值时,约登指数最大,敏感度86.7％,特异度70.0％,ROC曲线下面积=0.856.结论 以头晕为主诉的SBI患者存在较高的心理障碍,SSS具有较好的信度和效度,可用于帮助神经内科医生门诊时识别以头晕为主诉的SBI患者是否存在心理障碍.