慢性周围性头晕患者头部不适与焦虑抑郁程度的相关性研究

Study on the correlation between head discomfort and the status of anxiety and depression of patients with chronic vestibular peripheral dizziness

目的探讨慢性周围性头晕患者的焦虑抑郁程度与头部不适症状的关系。方法选择2017-01至2021-06就诊于武警河南总队医院耳鼻喉门诊的慢性周围性头晕患者275例,用自评量表(self-reporting inventory 90,SCL-90)进行心理状态评分,记录患者头部不适每一项主观症状出现的次数,分析其在焦虑、抑郁、寝食状态三个因子中出现的比例,并与健康对照组进行对比分析。然后通过药物治疗,SCL-90量表再次测定,比较治疗前后差异。结果慢性周围性头晕患者的SCL-90总均分平均为2.016±0.16,符合轻度心理健康损害,其中亚健康42例(15.5%),有轻度损害者196例(71.3%),中度损害者31例(11.2%),重度损害者6例(2.0%)。患者的焦虑、抑郁、强迫症状、躯体化和寝食障碍共5项因子分值高于健康对照组;八项头部不适症状中头晕在焦虑抑郁中出现的频率均较高,头痛、头胀、头响、头紧在焦虑患者中出现的比例高,而抑郁患者头懵、头沉、头昏的表现更突出。慢性周围性头晕患者药物治疗前后的SCL-90评分有统计学差异。结论慢性周围性头晕患者有轻度的心理健康损害;焦虑、抑郁、强迫症状、躯体化和其他(睡眠、饮食)最明显,头部不适可以部分反映患者的精神心理障碍,抗焦虑抑郁药物治疗可有效缓解患者的临床症状。

Objective To probe the correlation between head discomfort and the status of anxiety and depression of patients with chronic vestibular peripheral dizziness.Methods Psychological evaluation was performed in 275 patients with chronic vestibular peripheral dizziness using SCL-90 questionnaire.The results were compared with healthy controls.The relationship of head discomfort and psychological scores was analyzed.Before and after the treatment,the clinical efficacy of drug was evaluated according to the results.Results Mild and moderate levels of psychosis were respectively noted as 71.3%and 11.2%in patients with chronic vestibular peripheral dizziness,with high scores of anxiety,depression,enforcement,somatoform disorders and others(sleep and diet)as compared with healthy controls.The status of anxiety and depression was associated with eight forms of head discomfort.There was statistical difference in the scores of SCL-90 before and after treatment in both groups.Conclusions Psychiatric disorders are prevalent in patients with chronic vestibular peripheral dizziness,especially in the forms of depression,anxiety and disorders of sleep and diet.Head discomfort may reflect psychological problem,and drug treatment can reduce the physical symptoms and dysfunction.