偏头痛患者伴发焦虑/抑郁及功能残疾的临床研究

A clinical study of migraine associated with anxiety/depression and functional disability

目的调查偏头痛患者伴发焦虑、抑郁、睡眠障碍、偏头痛相关功能残疾及影响因素分析。方法采用焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)、匹兹堡睡眠量表(Pittsburgh sleep quality index,PQSI)、偏头痛残疾程度评估量表(migraine disability assessment scale,MIDAS)、头痛影响测验(headache impact test-6,HIT-6)调查问卷,分别对94例符合ICHD-II诊断标准的偏头痛患者和60例健康对照者焦虑、抑郁、睡眠障碍、偏头痛情况以及相关危险因素进行对比分析。结果偏头痛患者47.9%伴发焦虑;50.0%伴发抑郁,睡眠障碍发生率58.5%。偏头痛组焦虑、抑郁和睡眠障碍发生率都明显高于健康对照组的8.3%,16.7%,30.0%,(掊2分别为28.728,20.755,10.954,P值均<0.01)。多元逐步回归分析显示:头痛程度重、病程长、头痛家族史、睡眠质量差、生活满意度低是偏头痛并发焦虑/抑郁的主要危险因素。头痛程度、发作频率、持续时间、伴发焦虑/抑郁是导致功能残疾的主要影响因素。结论头痛程度、病程、家族史、睡眠质量、生活满意度是偏头痛并发精神心理症状的主要危险因素。

Objective To investigate the incidence and risk factors of migraine associated with anxiety, de- pression, sleep disorders, migraine related function disability in adult migraineurs. Methods Questionnaires of self- rating anxiety/depression scale （SAS/SDS）, Pittsburgh sleep quality index （PSQI）, migraine disability assessment （MIDAS） and headache impact test （HIT-6） were administered to 94 eligible migraineurs who meet ICHD-II diag- nostic criteria and 60 health subjects. The related risk factors of psychiatric comobidity and disability for migraineurs were further assessed. Results Incidence of migraine associated with anxiety was zt7.9%. Migraine associated with depression and sleep disorder occurred in 50.0% and. 58.5% of migraineurs, respectively. The anxiety/depression and sleeping disturbance comobidity were significantly higher in migraineurs than in controls （P 〈 0.01 ）. Multiple re- gression analysis showed that the heavy headache, long duration, positive headache family history, poor sleep quality and low satisfaction with life was the main risk factors attribute to migraine psychiatric comobidity. The headache severity degree, headache course, family history, sleeping quality and life satisfaction was the main influential factors for migraine-related disability. Conclusions The headache severity, duration, family history, sleeping quality and life satisfaction status are the main influence factors for migraine associated anxiety/depression.