躯体形式障碍患者心理健康状况及SPECT特征研究  

Mental health status and SPECT characteristics of patients with somatoform disorders

作　　者：孟祥生 王磊 李倩 郑荫荫 MENG Xiangsheng;WANG Lei;LI Qian(Hengshui Seventh People’s Hospital,Hengshui 053800,China)

机构地区：[1]衡水市第七人民医院,河北衡水053800

出　　处：《精神医学杂志》2024年第5期475-480,共6页Journal of Psychiatry

基　　金：2021年度河北省医学科学研究课题计划(编号:20211503)。

摘　　要：目的探究躯体形式障碍患者心理健康状况及单光子发射型计算机断层(SPECT)特征。方法选取躯体形式障碍患者180例进行前瞻性分析,采用症状自评量表(SCL-90)评估躯体形式障碍患者心理健康状况,采用多伦多述情障碍量表(TAS-20)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评估患者述情障碍、焦虑、抑郁状况,检查SPECT特征,并通过多元线性回归模型分析躯体形式障碍患者心理健康状况影响因素。结果180例躯体形式障碍患者SCL-90总均分为(2.50±0.41)分,处于中等水平。SPECT检查中,40%呈现阳性,60%呈现阴性,阳性SPECT表现特征为血流灌注减少。躯体形式障碍患者不同年龄、受教育程度、医疗费用支付方式、家庭关怀度、应对方式、SPECT特征的SCL-90总均分比较,差异均有统计学意义(P<0.001)。相关分析结果显示,SCL-90、TAS-20、HAMD、HAMA评分互呈正相关(P<0.001)。多元线性回归模型分析显示受教育程度高、医疗费用支付方式(公费医疗)、应对方式(积极应对)、SPECT特征(阴性)均是躯体形式障碍患者心理健康状况的保护因素(P<0.05),家庭关怀度、TAS-20评分、HAMA评分、HAMD评分均是躯体形式障碍患者心理健康状况的危险因素(P<0.05)。结论躯体形式障碍患者部分存在心理健康状况差与血流灌注减少状况,且躯体形式障碍患者心理健康状况受多种因素影响,临床需加强重视。Objective To explore the mental health status and single photon emission computed tomography(SPECT)characteristics of patients with somatoform disorders.Methods A total of 180 patients with somatoform disorders were selected for prospective analysis and assessed with Symptom Checklist-90(SCL-90),Toronto Alexithymia Scale-20(TAS-20),Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD)and SPECT features.Factors affecting the mental health status of the patients with somatoform disorders were analysed by multiple linear regression model.Results The total mean SCL-90 score of 180 patients with somatoform disorders was(2.50±0.41),which was at a moderate level.40%of the SPECT examinations were positive(72 cases),and 60%were negative(108 cases),and the SPECT performance of the positive group was characterised by decreased blood perfusion.There existed significant differences in SCL-90 scores among patients with different ages,educational levels,health care payment methods,family carings,coping methods and SPECT characteristics(P<0.001).Pearson correlation showed that SCL-90 score,TAS-20 score,HAMD score,and HAMA score were positively correlated with each other(P<0.001).Multiple linear regression model analyses showed that high educational level,health care payment method(public health care),coping method(active coping),and SPECT characteristic(negative)were protective factors for mental health status in patients with somatoform disorders(P<0.05),and family caring,scores of TAS-20,HAMD and HAMA were risk factors for mental health status in patients with somatoform disorders(P<0.05).Conclusion Some patients with somatoform disorders have poor mental health and reduced perfusion,and their mental health is affected by a variety of factors,which needs more clinical attention.

关 键 词：躯体形式障碍 心理健康状况 单光子发射型计算机断层 特征 

分 类 号：R749.2[医药卫生—神经病学与精神病学]