一起集体性癔症诱因、临床特征、干预措施的研究  

A study on inducements, clinical features and interventions in a case of mass hysteria

作　　者：钟衔江 张丽丽[1] 韩书贤 罗晓[1] 安治国[1] 伊琦忠[1] 

机构地区：[1]新疆医科大学第一附属医院心理医学中心,乌鲁木齐830054

出　　处：《中国神经精神疾病杂志》2014年第3期162-166,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：国家高技术研究发展计划(编号:2006AA02A407);国家自然科学基金(编号:81360209);新疆维吾尔自治区自然科学基金资助项目(编号:2010211A51)

摘　　要：目的探讨一起集体性癔症的诱因,描述其临床特征,并对干预措施进行总结。方法某工厂发生应激事件后54例患者诊断为集体性癔症,收集患者社会人口学资料、发病前情况和临床症状等,予以药物和心理治疗,并于治疗前及治疗1周、2周和4周后进行汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评定。结果患者平均(20.26±2.04)岁,女38例,男16例。患者均目击了斗殴事件过程,50例患者表示事件后最担心自身安全。47例(87.0%)患者出现痉挛或抽搐发作,分别有32例(59.3%)和29例(53.7%)患者出现情感爆发和发作性晕厥;癔症性精神障碍和躯体障碍混合发作者34例(62.96%)。治疗1周、2周和4周后的HAMA评分与治疗前相比均降低(均P<0.01)。结论目击斗殴事件、对自身安全的担心是本次集体性癔症的诱因,患者以癔症性精神障碍和躯体障碍混合发作为主要症状。控制集体性癔症流行的首要任务在于缓解人群的焦虑情绪。Objective To explore the clinical features, inducements and interventions in a case of mass hysteria. Methods A mass hysteria strook after a fight gang in a factory. Fifty-four cases were diagnosed as mass hysteria. The general information and clinical symptoms of all patients with mass hysteria were collected. All patients were assessed us- ing Hamilton anxiety scale （HAMA） before treatment, and at the end of one, two and four weeks of the treatment, respec- tively. Results The patients were thirty-eight females （70.4%） and sixteen males （29.6%）, with average age （20.26_＋2.04） years old. Fifty patients showed anxious about self-safety mostly. The most common symptoms were convulsions or con- vulsive seizure in forty-seven cases （87.0%）, outburst of emotion in thirty-two cases （59.3%）, and episodic syncope in twenty-nine cases （53.7%）. Thirty-four cases （62.96%） were disscoiative disorders mixed with conversion disorders. The scores of HAMA at the end of one, two and four weeks of the treatment were lower than that before treatment （all P〈 0.05）. Conclusions The inducements of such an episode of mass hysteria are witness of fighting and the overwhelming anxiety about self-security. Disscoiative disorders mixed with conversion disorders is the major clinical feature. In order to control the episode of mass hysteria, the priority task is to relieve people＇s anxiety.

关 键 词：集体性癔症 集体性心因性疾病 临床特征 干预措施 

分 类 号：R749.7[医药卫生—神经病学与精神病学]