重庆地区农村留守儿童癔症的发生及干预  

Occurrence and intervention of hysteria in left-behind children in Chongqing rural area

作　　者：胡君[1] 蒋莉[1] 洪思琪[1] 李秀娟[1] 郭艺[1] 孔敏[1] 叶园珍[1] 

机构地区：[1]重庆医科大学附属儿童医院神经内科,400014

出　　处：《中华实用儿科临床杂志》2013年第2期138-140,共3页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的探讨重庆地区农村留守儿童癔症患儿的临床特征及干预效果，以期对其早发现、早治疗和预防提出参考依据。方法回顾性分析2008年6月至2011年6月确诊的103例7—17岁农村留守儿童癔症患儿的一般资料、临床表现及综合干预措施。采用艾森克个性问卷（EPQ）、症状自评量表（SCL-90）行心理测验；依据简明精神症状评定量表（BPRS）评定临床疗效。结果103例患儿中，72例（69．90％）临床表现为躯体功能障碍（转换型），以瘫痪、痉挛发作多见；26例（25．24％）为躯体功能障碍＋精神症状（混合发作），5例（4．9％）为精神症状（分离型）。综合干预3—12d后，痊愈78例（75．73％），显著进步19例（18．45％），进步6例（5．83％）。19例患儿EPQ测试结果显示，12例（63．16％）为不稳定型个性；干预7～12d后，SCL-90的躯体化、人际关系、抑郁、焦虑、敌对因子分值显著降低，与治疗前比较，差异有统计学意义（P均〈0．05）。结论重庆地区农村留守儿童癔症患儿主要表现为瘫痪、痉挛发作及混合发作，个性特征以不稳定型多见。重视亲子之间的情感交流，早发现、早治疗和积极预防可取得良好疗效。Objective To analyze the clinical characteristics and the interventional effects of hysteria in left- behind children in Chongqing rural area for early detection, early treatment and prevention of the disease. Methods One hundred and three left-behind children aged from 7 to 17 years were diagnosed as hysteria from Jun. 2008 to Jun. 2011. Their general information,clinical presentations were analyzed retrospectively. After comprehensive intervention, they were assessed the clinical efficacy in accordance with Brief Psychiatric Rating Scale, and some of them were tested by Eysenck Personality Questionnaire （EPQ） and Symptom Checklist （SCL-90）. Results There were many clinical forms of hysteria in 103 left-behind children. Physical dysfunction accounted for 72 cases（69.90% ） ,whose symptoms were mainly paralysis and convulsive seizure, which was significantly higher than mental disorder（5 cases ,4.9% ）. The mixed episode of physical dysfunction and mental disorder accounted for 26 cases （ 25.40% ）. Seventy-eight cases （75.73 % ） were cured, 19 cases （ 18.45 % ） improved significantly, and 6 cases （ 5.83 % ） improved respectively after intervention of 3 to 12 days. Emotional instability accounted for 12 cases（63.16% ） in personality factors with EPQ test in 19 cases. Their factors of somatization, interpersonal relationship, depression, anxiety, and hostility with SCL-90 sig- nificantly decreased（ all P 〈 0. 05） after intervention of 7 to 12 days. Conclusions The main forms of hysteria in left- behind children in Chongqing rural area are physical dysfunction and mixed episode,which are paralysis and convulsive seizure. Emotional instability is common in personality factors for them. It can be achieved good results of hysteria in left-behind children to pay attention to the emotional exchange between the children and their parents, early detect, early treat and active prevent the disease.

关 键 词：癔症 临床特征 干预 留守儿童 

分 类 号：R74[医药卫生—神经病学与精神病学]