外周性眩晕患者的精神心理评估

摘要

目的 评价外周性眩晕患者的精神心理状态,分析影响眩晕患者精神心理的相关因素.方法 对253例眩晕患者,进行UCLA眩晕问卷、HAMA量表和HAMD量表调查评估患者的精神心理状态,并对眩晕的可能影响因素进行逻辑回归.结果 在接受测试的253例眩晕患者中有122人(48.22％)HAMA结果异常,85人(33.60％) HAMD结果异常.研究结果显示①随着病程逐渐延长,HAMA的平均分值逐渐增高,差异具有统计学意义(P=0.014),而HAMD得分之间无明显变化,差异无统计学意义.②随着眩晕发作频率逐渐增高,焦虑、抑郁的比率有增高趋势,以焦虑为主,组间差异有统计学意义.③前庭功能是否异常对HAMA、HAMD结果无显著影响.④逻辑回归提示,若眩晕患者为女性且发作频率较高则更容易出现焦虑和抑郁状态.结论 眩晕患者可出现不同程度焦虑和/或抑郁情绪,其中焦虑倾向更为明显.女性患者容易出现精神心理情绪问题,眩晕发作频率会影响患者的心理感受.%Objective To evaluate psychological condition of patients with vertigo and to study the affected factors of psychological condition. Methods A total of 253 patients with vertigo visited Tongren hospital from May to July in 2010. We investigated patients' psychological condition with UCLA Dizziness Questionnaire, Hamilton Anxiety Scale and Hamilton Depression Scale, and further analyzed the possible affected factors using logistic regression. Results The number of abnormal HAMA result was 122(48. 22% ) and abnormal result HAMD is 85(33. 60% ).① Patients were grouped on the basis of course of disease, mean score of HAMA increase along with the course, however, HAMD score had no such difference. ② Patients were grouped on frequency of vertigo attack, the abnormal ratio of anxiety and depression raise along with the raised frequency. The result of one-way ANOVA test and nonparametric test was significantly different. ③ The score of HAMA and HAMD between the group of normal vestibular function and abnormal vestibular function was not significantly different.④ The result of logistic regression suggested that female patients and the patients having more attack of vertigo were much easier to develop anxiety and depression. Conclusion Patients with vertigo had different degrees of anxiety and depression and anxiety was worse. The probability of anxiety was much higher. Female patients were prone to to develop the psychological problems. Increased frequency of vertigo attack will lay more pressure on patients with vertigo. We should not only treat the diseases but also lower the pressure on mind.