鼻中隔偏曲及慢性咽炎患者的焦虑抑郁状况比较
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摘要
目的调查门诊及住院的以鼻部及咽部症状为主诉,伴有可疑精神症状的患者,了解鼻中隔偏曲及慢性咽炎患者中焦虑/抑郁心理状况的流行情况。方法入选鼻中隔偏曲患者24例及慢性咽炎患者32例,使用统一的问卷调查表,包括一般资料问卷表、焦虑自评量表(self-rating anxiety scale,SAS),以及抑郁自评量表(self-rating depression scale,SDS)等,均采取当面询问的方式,统一相关的指导语和填表方法,最终完成完整的问卷调查,并对数据进行相关的统计学分析。结果 24例鼻中隔偏曲患者的SAS、SDS标准分平均值分别为45.61±7.63、42.5±8.19,其中14例存在焦虑,2例患者合并有焦虑、抑郁心理障碍。32例慢性咽炎患者的SAS、SDS标准分平均值分别为41.58±7.05、48.34±8.92,其中5例存在焦虑,13例存在抑郁,1例患者合并有焦虑、抑郁心理障碍。鼻中隔偏曲组患者较慢性咽炎组焦虑评分显著升高,差异有统计学意义(P<0.05)。慢性咽炎组患者较鼻中隔偏曲组抑郁评分显著升高,差异有统计学意义(P<0.05)。结论鼻中隔偏曲及慢性咽炎患者中,存在心理障碍的患者比例较高,且鼻中隔偏曲组患者焦虑程度高,慢性咽炎患者抑郁程度高,两者表现有所不同。对于有心理问题的患者,需实施必要的干预措施,避免负面情绪的累积,减少"弑医"等恶性事件的发生。
Objective To investigate the prevalence of anxiety and depression in patients with nasal septum deviation and chronic pharyngitis by investigating the nasal and pharyngeal symptoms of the outpatient and hospitalization patients with suspected psychological symptoms. Methods The study included 24 cases of patients with nasal septum deviation and 32 cases of patients with chronic pharyngitis, and used a unified questionnaire, including general information questionnaire, self-rating anxiety scale(SAS) and self-rating depression scale(SDS). The unified questionnaire was completed through interview by unified instruction and form-filling method. Result The average of SAS and SDS in 24 patients with nasal septum deviation were 45.61±7.63 and 42.5±8.19, of which 14 patients had anxiety and 2 patients had anxiety and depressive disorder. The average of SAS and SDS in 32 patients with chronic pharyngitis were 41.58 ±7.05 and 48.34 ±8.92, of which 5 cases had anxiety, 13 cases had depression, 1 case had anxiety and depression psychological disorder. The anxiety scores of patients with nasal septum deviation were significantly higher than those in chronic pharyngitis group, and the difference was statistically significant(P <0.05). The depression scores of patients with chronic pharyngitis were significantly higher than those in the nasal septum deviation group, and the difference was statistically significant(P<0.05). Conclusion In patients with nasal septum deviation and chronic pharyngitis, the proportion of patients with mental disorders is high. Meanwhile the degree of anxiety in patients with nasal septum deviation is higher and the degree of depression in patients with chronic pharyngitis is higher. For patients with psychological problems, it is needed to implement the necessary interventions and to avoid the accumulation of negative emotions and the malignant events occurrence such as"Murder on doctor".
Objective To investigate the prevalence of anxiety and depression in patients with nasal septum deviation and chronic pharyngitis by investigating the nasal and pharyngeal symptoms of the outpatient and hospitalization patients with suspected psychological symptoms. Methods The study included 24 cases of patients with nasal septum deviation and 32 cases of patients with chronic pharyngitis, and used a unified questionnaire, including general information questionnaire, self-rating anxiety scale(SAS) and self-rating depression scale(SDS). The unified questionnaire was completed through interview by unified instruction and form-filling method. Result The average of SAS and SDS in 24 patients with nasal septum deviation were 45.61±7.63 and 42.5±8.19, of which 14 patients had anxiety and 2 patients had anxiety and depressive disorder. The average of SAS and SDS in 32 patients with chronic pharyngitis were 41.58 ±7.05 and 48.34 ±8.92, of which 5 cases had anxiety, 13 cases had depression, 1 case had anxiety and depression psychological disorder. The anxiety scores of patients with nasal septum deviation were significantly higher than those in chronic pharyngitis group, and the difference was statistically significant(P <0.05). The depression scores of patients with chronic pharyngitis were significantly higher than those in the nasal septum deviation group, and the difference was statistically significant(P<0.05). Conclusion In patients with nasal septum deviation and chronic pharyngitis, the proportion of patients with mental disorders is high. Meanwhile the degree of anxiety in patients with nasal septum deviation is higher and the degree of depression in patients with chronic pharyngitis is higher. For patients with psychological problems, it is needed to implement the necessary interventions and to avoid the accumulation of negative emotions and the malignant events occurrence such as"Murder on doctor".
引文
1吕萍,喻元凤,甘卫刚,等.伴耳鼻咽喉疾病焦虑抑郁症的诊治体会(附20例报告)[J].川北医学院学报, 2013,28(1):45-47.
2 郭朝斌,高娴.变应性鼻炎患者的心理健康状况分析[J].中国中西医结合耳鼻咽喉科杂志,2011,19(5):349-352.
3 蒋美媛.黛力新治疗老年冠心病伴焦虑抑郁的效果观察[J].广西医学,2013, 35(9):1199-1201.
4 Mormont E, Jamart J, Jacques D. Symptoms of depression and anxiety after the disclosure of the diagnosis of Alzheimer disease[J]. J Geriatr Psychiatry Neurol, 2014, 27(4):231-236.
5 安然,田霖丽,刘鸣,等.鼻中隔偏曲患者焦虑及抑郁状态分析[J].临床耳鼻咽喉头颈外科杂志,2016,30(1):35-38.
6 Sahlstrand-Johnson P, Ohlsson B, Von Buchwald C, et al.A multi-centre study on quality of life and absenteeism in patients with CRS referred for endoscopic surgery[J].Rhinology, 2011, 49(4):420-428.
7 董频,黄若飞.鼻腔疾病与精神异常的联系—“空鼻症”与“类空鼻综合征”[J].中国医学文摘(耳鼻咽喉科学),2014,29(1):19-21.
8 赵宇.“空鼻症”的认识和思考[J].中国医学文摘(耳鼻咽喉科学),2014,29(4):227-228.
9 Nanayakkara JP, Igwe C, Roberts D, et al. The impact of mental health on chronic rhinosinusitis symptom scores[J].Eur Arch Otorhinolaryngol, 2013, 270(4):1361-1364.
10 傅云春.咽异感症患者心理因素评析及心理干预疗效分析[J].山东大学耳鼻喉眼学报,2014,28(6):47-49.
11 Tomoum MO, Klattcromwell C, Del Signore A, et al.Depression and anxiety in chronic rhinosinusitis[J]. Int Forum Allergy Rhinol, 2015, 5(8):674-681.
12 Simopoulos E, Katotomichelakis M, Gouveris H, et al. Olfaction-associated quality of life in chronic rhinosinusitis:adaptation and validation of an olfaction-specific questionnaire[J]. Laryngoscope, 2012, 122(7):1450-1454.
13 Remenschneider AK, D'Amico L, Litvack JR, et al.Long-Term Outcomes in Sinus Surgery:A New Tool for Measuring Health-Related Quality of Life[J]. Otolaryngol Head Neck Surg, 2014, 151(1):164-170.
14 Tomljenovic D, Pinter D, Kalogjera L. Perceived stress and severity of chronic rhinosinusitis in allergic and nonallergic patients[J]. Allergy Asthma Proc, 2014, 35(5):398-403.
15 赵春丽,张道行,李革临.焦虑、抑郁与声带息肉发病的相互关系.中国中西医结合耳鼻咽喉科杂志,2013,21(6):434-436.
2 郭朝斌,高娴.变应性鼻炎患者的心理健康状况分析[J].中国中西医结合耳鼻咽喉科杂志,2011,19(5):349-352.
3 蒋美媛.黛力新治疗老年冠心病伴焦虑抑郁的效果观察[J].广西医学,2013, 35(9):1199-1201.
4 Mormont E, Jamart J, Jacques D. Symptoms of depression and anxiety after the disclosure of the diagnosis of Alzheimer disease[J]. J Geriatr Psychiatry Neurol, 2014, 27(4):231-236.
5 安然,田霖丽,刘鸣,等.鼻中隔偏曲患者焦虑及抑郁状态分析[J].临床耳鼻咽喉头颈外科杂志,2016,30(1):35-38.
6 Sahlstrand-Johnson P, Ohlsson B, Von Buchwald C, et al.A multi-centre study on quality of life and absenteeism in patients with CRS referred for endoscopic surgery[J].Rhinology, 2011, 49(4):420-428.
7 董频,黄若飞.鼻腔疾病与精神异常的联系—“空鼻症”与“类空鼻综合征”[J].中国医学文摘(耳鼻咽喉科学),2014,29(1):19-21.
8 赵宇.“空鼻症”的认识和思考[J].中国医学文摘(耳鼻咽喉科学),2014,29(4):227-228.
9 Nanayakkara JP, Igwe C, Roberts D, et al. The impact of mental health on chronic rhinosinusitis symptom scores[J].Eur Arch Otorhinolaryngol, 2013, 270(4):1361-1364.
10 傅云春.咽异感症患者心理因素评析及心理干预疗效分析[J].山东大学耳鼻喉眼学报,2014,28(6):47-49.
11 Tomoum MO, Klattcromwell C, Del Signore A, et al.Depression and anxiety in chronic rhinosinusitis[J]. Int Forum Allergy Rhinol, 2015, 5(8):674-681.
12 Simopoulos E, Katotomichelakis M, Gouveris H, et al. Olfaction-associated quality of life in chronic rhinosinusitis:adaptation and validation of an olfaction-specific questionnaire[J]. Laryngoscope, 2012, 122(7):1450-1454.
13 Remenschneider AK, D'Amico L, Litvack JR, et al.Long-Term Outcomes in Sinus Surgery:A New Tool for Measuring Health-Related Quality of Life[J]. Otolaryngol Head Neck Surg, 2014, 151(1):164-170.
14 Tomljenovic D, Pinter D, Kalogjera L. Perceived stress and severity of chronic rhinosinusitis in allergic and nonallergic patients[J]. Allergy Asthma Proc, 2014, 35(5):398-403.
15 赵春丽,张道行,李革临.焦虑、抑郁与声带息肉发病的相互关系.中国中西医结合耳鼻咽喉科杂志,2013,21(6):434-436.