综合医院儿童精神科联络会诊中躯体化症状障碍患儿焦虑症状、抑郁症状和自我意识的分析

Analysis of anxiety symptoms,depressive symptoms,and self-consciousness in children with somatic symptom disorder in the joint consultation of Departments of Pediatrics and Psychiatry in a general hospital

目的探讨综合医院儿童精神科联络会诊中躯体化症状障碍(SSD)患儿的焦虑症状、抑郁症状和自我意识及其影响因素。方法选取83例SSD患儿作为研究对象,依据症状表现分为神经系统症状组(n=44)和消化系统症状组(n=39)。比较两组焦虑症状、抑郁症状和自我意识,应用多因素Logistic回归模型分析SSD患儿自我意识的影响因素。结果神经系统症状组的儿童焦虑性情绪障碍筛查量表总分、社交恐怖因子分和学校恐怖因子分均高于消化系统症状组,消化系统症状组儿童自我意识量表的焦虑因子分高于神经系统症状组(均P<0.05)。多因素Logistic回归模型分析结果显示,人际关系、独生子女、焦虑症状、抑郁症状均是SSD患儿自我意识的影响因素(均P<0.05)。结论综合医院儿童精神科联络会诊中不同症状表现的SSD患儿的焦虑症状和自我意识水平不同,患儿的自我意识跟人际关系、是否独生子女、焦虑症状和抑郁症状均有关,对SSD患儿的治疗应更多关注其情绪状态,提高其自我意识。

Objective To investigate the anxiety symptoms and depressive symptoms,as well as self-awareness and its influencing factors,in children with somatic symptom disorder(SSD)in the joint consultation of Departments of Pediatrics and Psychiatry in a general hospital.Methods A total of 83 children with SSD were selected as the study subjects and divided into a neurological symptom group(n=44)or a digestive symptom group(n=39)according to their symptoms.Anxiety symptoms,depressive symptoms,and self-awareness were compared between the two groups,and the multivariate logistic regression model was used to analyze influencing factors of self-awareness in children with SSD.Results The total score of The Screen for Child Anxiety Related Emotional Disorders and the scores of its social phobia and school anxiety subscales of the neurological symptom group were higher than those of the digestive symptom group,and the freedom from anxiety subscore of Piers‑Harris Children's Self‑Concept Scale of the digestive symptom group was higher than that of the neurological symptom group(all P<0.05).The results of multivariate logistic regression model analysis showed that interpersonal relationships,being the only child,anxiety symptoms,and depressive symptoms were influencing factors of self-awareness in children with SSD(all P<0.05).Conclusion The anxiety symptoms and the self-awareness level differ between children with SSD with different symptoms in the joint consultation of Departments of Pediatrics and Psychiatry in a general hospital,and the self-awareness of children with SSD is related to interpersonal relationships,whether they are the only child,anxiety symptoms,and depressive symptoms.Therefore,in the treatment of children with SSD,more attention should be paid to their emotional state and improving their self-consciousness.