疑病症的临床及认知功能特点研究

Study on the clinical characteristics and cognitive function of hypochondriasis

目的探讨疑病症患者的临床特征及认知功能特点。方法选取2015年1~12月间在浙江大学医学院附属第一医院就诊的疑病症患者(疑病症组)44例和健康对照者(对照组)42例,使用汉密尔顿抑郁量表(Hamilton's depression scale items,HAMD)、汉密尔顿焦虑量表(Hamilton's anxiety scale,HAMA)评定临床症状,使用精神分裂症认知功能成套测验共识版(MATRICS consensus cognitive battery,MCCB)评定疑病症患者的认知功能。结果疑病症组HAMD、HAMA评分显著高于对照组(tHAMD=18.61,P<0.01;tHAMA=16.85,P<0.01)。在MCCB测试中,疑病症组在注意/警觉性、工作记忆、词语学习、视觉学习、推理和问题解决、社会认知的分数及总体综合分数显著低于对照组(P均<0.01)。控制了年龄、性别、受教育年限影响因素以后,疑病症组HAMD评分、HAMA评分与注意/警觉性、工作记忆、词语学习、视觉学习、推理和问题解决、社会认知领域及总体综合分数成负相关(P均<0.05)。结论疑病症患者存在抑郁和焦虑情绪且有认知功能损害。

Objective To investigate the clinical characteristics and cognitive function of patients with hypochondriasis. Methods 44 patients with hypoehondriasis（hypochondriasis group） and 42 healthy controls（control group） were selected from the First Affiliated Hospital of Zhejiang University from January to December 2015. The clinical symptoms were assessed using the Hamilton＇s depression scale items（HAMD） and the Hamilton＇s anxiety seale（HAMA）, and the cogni- tive function was assessed by the MATRICS consensus cognitive battery（MCCB）. Results The scores of HAMD and HAMA in the hypoehondriasis group were significantly higher than the control group（tHAMD=18.61, P〈0.01 ;tHAMA=16.85, P〈0.01）. In the MCCB test, the scores of attention/alertness, working memory, vocabulary learning, visual learning, reasoning and problem solving, social cognition and overall score were significantly lower in the hypochondriasis group than those in the control group（all P〈0.01）. HAMA score, HAMA score showed negative correlation with attention/alertness, working memory, vocabulary leaming, visual learning, reasoning and problem solving, social cognition and overall composite scores after controlling for age, sex and education years（all P 〈0.05）. Conclusion Patients with hypoehondriasis have depression, anxiety and cognitive impairment.