以头晕为主诉的神经内科门诊患者焦虑和抑郁的特征性分析

Analysis of the characteristics of anxiety and depression in neurology outpatients with dizziness as the chief complaint

目的对以头晕为主诉的神经内科门诊患者焦虑和抑郁的特征进行分析。方法收集2017年1~10月在首都医科大学附属北京天坛医院神经内科门诊就诊的以头晕为主诉的163例患者的临床资料,进行汉密尔顿焦虑量表和汉密尔顿抑郁量表评测。结果本组163例头晕患者中,伴焦虑者占92.0%,伴抑郁者占63.8%,有、无焦虑的两组头晕患者在焦虑心境等8项及躯体性因子得分和精神性因子得分2项评分均有显著差异(P均<0.001),而在呼吸系统症状等4项也存在差异(P均<0.05);有、无抑郁的两组头晕患者抑郁因子评分中的6项均有显著差异(P均<0.001),在体重项也存在差异(P<0.05)。结论头晕患者均有很高的焦虑或是抑郁伴发率,且伴发焦虑或抑郁的患者会影响躯体诸多系统并出现该系统的特征表现,临床中在诊断和治疗上均应予以重视。

OBJECTIVE To analyze and study the characteristics of anxiety and depression in patients with dizziness as the chief complaint in neurology outpatient clinic.METHODS From January 2017 to October 2017,the clinical data of 163 patients who attended the neurology outpatient clinic of Beijing Tiantan Hospital affiliated to Capital Medical University were selected.All patients had the chief complaint of dizziness.Both Hamilton anxiety scale and Hamilton depression scale were performed to statistically analyze the incidence of anxiety and depression and the characteristics of each relevant factor of anxiety and depression in these patients.RESULTS Among163 patients with dizziness,92% of them(Possible and Confirmed) were diagnosed as anxiety;63.8% of them(Possible and Confirmed) were diagnosed as depression.There were significant differences between patients with and without dizziness in anxiety state of mind,tension,insomnia,memory or attention disorders,muscular system symptoms,sensory system symptoms,cardiovascular system symptoms,behavior during talks,and both somatic and psychogenic factor score(P<0.001),while there were significant differences in depression state of mind,respiratory symptoms,genitourinary symptoms,and vegetative nervous system symptoms(P<0.05).There were significant differences between patients with and without dizziness in depression state of mind,the anxiety somatization,cognitive impairment,day-night variation,blocking,sleep disturbance,and sense of despair in factor scores(P<0.001),and also in weight(P<0.05).CONCLUSION Patients with dizziness have a high prevalence of both anxiety and depression,which affect many somatic systems and have their own manifestations.Overall,in terms of diagnosis and treatment,patients with dizziness should be taken seriously.