青年缺血性卒中心理状态

The psychological status of ischemic stroke in the young

目的评估青年缺血性卒中后心理状态。方法入选2008年3月～2011年3月期间两院90例青年缺血性卒中患者,男58例,女32例,年龄21～45岁。使用中国版SCL-90评估心理状态,测量值与常模比较。结果和常模比较,青年缺血性卒中测量值在抑郁,焦虑,躯体化症状,恐惧,厌恶和精神症状方面差别有统计学意义(P<0.01),而在强迫、敌意和妄想方面的差异无统计学意义(P>0.05)。抑郁/焦虑的发生率是43.33%,其中女性占75%,男性占25%(P<0.01)。受教育程度差异无统计学意义(P>0.05)。医保患者抑郁/焦虑发生率是29.2%,低于自费患者的发生率(66.7%,P<0.05)。脑损伤部位与抑郁/焦虑发生率有关,双重大脑半球缺血者的发生率是75%(P<0.05)。结论青年缺血性卒中伴有抑郁、焦虑、躯体化症状、人际关系敏感、恐惧和精神症状,但是强迫、敌意和妄想与常模没有明显的差异。性别、医疗费用和缺血部位影响抑郁/焦虑的发生率。

Objective To evaluate the psychological status of ischemic stroke in the young. Method 90 patients （58 men, 32 women; age range 21 -45 years） with ischemic stroke at department of neurology, Ningxia People/s Hospital and department of rehabilitation, the second Affiliated Hospital of Qingdao University Medical College, during March 2008 and March 2011, were included. Psychological distress was evaluated with Symptom Distress Checklist （ SCL-90, Chinese version）. The scores of distress symptom according to the completed SCL-90 were analyzed statistically compared with China Psychological Norm. Result Compared with the norm, there were significant differences in aspects of depression, anxiety, somatization, phobia and psychoticism （P 〈 0. 01, P 〈 0. 001, respectively）, and no significant change in obsessiveness-compulsiveness, hostility and paranoid ideation （P 〉 0.05 respectively）. The occurrence of depression/anxiety was 43.33%. Female was 75% , and male was 25% （ P 〈 0. 01 ）. Education levels made no difference （P 〉 0.05 ）. The economic burden made differences. The occurrence of depression/anxiety was 29.2% in patients whose medical payment was covered by medical insurance, and 66.7% in patients without medical insurance （ P 〈 0.05 ）. The occurrence of depression/anxiety was 75% with bilateral hemispheres injures （ P 〈 0.05 ）. Conclusion The psychological reactions of the young to the ischemic stroke were depression, anxiety, somatization, interpersonal sensitivity, phobic anxiety, and psychoticism. Different sex, payment method and injured regions were factors of psychological reactions in the young with ischemic stroke.