SARS患者心理健康状况随访研究

Follow-up study on mental symptoms of SARS patients

目的追踪研究SARS患者入院、出院及出院3个月后3个阶段心理状况及影响因素,对有心理问题的SARS患者进行心理干预并进行干预效果评价。方法采用自拟一般状况调查表、症状自评量表(SCL-90)、领悟社会支持量表(PSSS)、简易应对方式问卷(SCSQ)、自尊量表(SES)、艾森克个性问卷(EPQ)作为工具,对114名SARS患者进行追踪调查。结果1.SCL-90总分、强迫、恐怖因子分出院较入院时有上升[均分分别为(153.34±62.72)分/(150.50±56.66)分,(1.80±0.80)分/(1.71±0.71)分,(1.48±0.74)分/(1.38±0.63)分],之后开始下降[均分分别为(138.47±50.91)分/(153.34±62.72)分,(1.76±0.78)分/(1.80±0.80)分,(1.36±0.61)分/(1.48±0.74)分];躯体化、抑郁、焦虑因子分随时间变化逐渐下降[均分分别为(1.85±0.90)分/(1.77±0.84)分/(1.60±0.75)分,(1.81±0.87)分/(1.78±0.85)分/(1.59±0.75)分,(1.79±0.78)分/(1.76±0.84)分/(1.50±0.66)分]。2.强迫、人际敏感、恐怖问题发生率,出院时较入院时上升,之后开始下降(P>0.05)。其他因子发生率,随着时间的推移逐渐下降(焦虑发生率由0.298降到0.289再降到0.14,P<0.05)。3.自尊在3个研究阶段均是SARS患者心理症状的影响因素;自觉病情严重程度是从入院到出院时的影响因素;消极应对是从出院和出院后3月时的影响因素;文化程度是出院后3月时的影响因素。4.电话心理干预后SARS患者SCL-90总分及大部分因子分下降(P>0.05),部分因子分尤其躯体化(P<0.01)反而上升[躯体化由(1.58±0.78)分上升到(2.08±0.82)分,P<0.01]。结论1.SARS患者在各期均存在明显的情绪障碍且影响因素不完全相同,临床应该持续评估其心理状态,并进行及时干预。2.经心理干预后SARS患者心理症状减轻不明显,部分症状反而加重。

Objective To investigate mental symptoms of SARS patients and its related factors for three periods-admission, discharge and three months after SARS crisis and to carry out mental intervention and effect evaluation. Methods 114 SARS patients were assessed by scale of self-compiled Common Status Questionnaire, SCL-90, PSSS, SCSQ, SES and EPQ. Results 1. The SCL-90 total and factors scores including obsessive-compulsion, phobic anxiety went up during discharge compared with admission score： 153.34±62.72/150.50± 56.66,1.80±0.80/1.71 ± 0.71,1.48 ± 0.74/1.38 ± 0.63. After that, these factors scores went score ： 138.47 ± 50.91/153.34 ± 62.72,1.76 ± 0.78/1.80 ± 0.80,1.36 ± 0.61/1.48 ± 0.74 down. The factors scores of somatization and depression descended continuously for three period score ： 1.85 ± 01 90/1.77 ± 0.84/1.60 ± 0.75, 1.81± 0.87/1.78 ±0.85/1.59 ± 0.75,1.79 ± 0.78/1.76 ± 0.84/1.50 ± 0.66. 2. The incidence on factors of obsessive-compulsive, interpersonal sensitivity, phobic anxiety ascended during discharge compared with admission. Then, these factors scores descended. The other factors went down continually for three periods （ P 〈 0.05 ; Anxiety incidence decreased from 0. 298 to 0. 289 to 0.14, P 〈 0.05）. 3. The self-esteem was influencing factor on mental symptoms of SARS patients for three periods. Conscientious condition severity was influencing factor in admission and discharge. Negative coping was influencing factor in discharge and three months after SARS crisis. Education was influencing factor in three months after SARS crisis. 4. After intervention, the most mental symptoms of 35 SARS patients had mental problems were improved. Dissimilarly, a part of mental symptoms got severity （ Somatization score increased from 1.58 ± 0.78 to 2.08 ±0.82, P 〈 0.01 ）. Conclusions 1. SARS patients exist severe mood disorders and have different influencing factors for three periods. They should be evaluated continuously and be intervened in time. 2. The effect of mental intervention by telephone is not uncertainty.