CAJ | 학술논문

背景:脑卒中后情绪障碍以焦虑、抑郁常见,但是有关老年脑梗死患者恢复期情绪障碍的研究报告较少.目的:探讨老年脑梗死患者恢复期情绪障碍的特点以及情绪障碍与神经功能障碍的关系.设计:病例-对照研究.单位:苏州市广济医院精神科和苏州市第二人民医院神经内科.对象:2001-05/2003-06苏州市第二人民医院神经内科住院后出院的患者87例(病例组),男48例,女39例,年龄61～84岁.均首次发病,病程在第3个月的恢复期者.选择本院健康体检人员68例为对照组,神经系统检查和躯体检查正常,无精神病史,无痴呆表现,男39例,女29例,年龄60～82岁.方法:根据统一的指导语,在病程第3个月完成症状自评量表(SCL-90)和改良爱丁堡-斯堪的那维亚量表(SSS)评定,一致性检验Kappa值为0.82.主要观察指标:①SCL-90总分和因子分.②SSS总分.结果:病例组SCL-90总分、阳性项目、阳性总分、阳性均分均高于对照组(t=4.14～8.09,P=0.000).病例组SCL-90躯体化因子、强迫因子、人际关系因子、抑郁因子、焦虑因子、恐怖因子、精神病性因子评分高于对照组(u=2.107～8.811,P=0.000).两组在敌对和偏执因子的差异无统计学意义(P＞0.05).病例组SCL-90总分及因子分与神经功能缺损总分呈正相关(r=0.806～0.293,P＜0.01).结论:老年脑梗死患者恢复期常见抑郁、焦虑和恐怖等情绪障碍.其情绪障碍与神经功能缺损的严重程度有关.
배경:뇌졸중후정서장애이초필、억욱상견,단시유관노년뇌경사환자회복기정서장애적연구보고교소.목적:탐토노년뇌경사환자회복기정서장애적특점이급정서장애여신경공능장애적관계.설계:병례-대조연구.단위:소주시엄제의원정신과화소주시제이인민의원신경내과.대상:2001-05/2003-06소주시제이인민의원신경내과주원후출원적환자87례(병례조),남48례,녀39례,년령61～84세.균수차발병,병정재제3개월적회복기자.선택본원건강체검인원68례위대조조,신경계통검사화구체검사정상,무정신병사,무치태표현,남39례,녀29례,년령60～82세.방법:근거통일적지도어,재병정제3개월완성증상자평량표(SCL-90)화개량애정보-사감적나유아량표(SSS)평정,일치성검험Kappa치위0.82.주요관찰지표:①SCL-90총분화인자분.②SSS총분.결과:병례조SCL-90총분、양성항목、양성총분、양성균분균고우대조조(t=4.14～8.09,P=0.000).병례조SCL-90구체화인자、강박인자、인제관계인자、억욱인자、초필인자、공포인자、정신병성인자평분고우대조조(u=2.107～8.811,P=0.000).량조재활대화편집인자적차이무통계학의의(P＞0.05).병례조SCL-90총분급인자분여신경공능결손총분정정상관(r=0.806～0.293,P＜0.01).결론:노년뇌경사환자회복기상견억욱、초필화공포등정서장애.기정서장애여신경공능결손적엄중정도유관.
BACKGROUND: Anxiety and depression are common in mood disturbance after cerebral apoplexy. However, there are few researches about mood disturbance in convalescent stage of senile cerebral infarct.OBJECTIVE: To investigate the characteristics of mood disturbance in convalescent stage of senile cerebral infarct and the relationship between mood disturbance and neural dysfunction.DESIGN: A case-controlled trial.SETTING: Department of Psychiatrics, Guangji Hospital and Department of Neurology, the Second People' s Hospital of Suzhou City.PARTICIPANTS: A total of 87 discharged patients(case group) including48 male and 39 female patients aged between 61 and 84 years old were selected from the inpatient department of Neurology of the Second People' s Hospital of Suzhou City during May 2001 and June 2003. They were all attacked for the first time, which were all convalescents in their 3rd months. A total of 68 healthy volunteers including 39 male and 29 female subjects aged between 60 and 82 years old who attended for physical check-up in our hospital were selected in control group, which had normal nervous system and physical check-up, no previous history of psychopathy, and no dementia.INTERVENTIONS: Patients were evaluated with symptom check list(SCL)-90 and modified SSS scales on the 3rd month of the course of disease with unified instructive language. Kappa was set at 0. 82 for consistency.MAIN OUTCOME MEASURES: ① SCL-90 total score and factor score;② SSS total score.RESULTS: SCL-90 total score, positive items, scores for positive items,and mean for positive scores of case group were significantly higher than that of control group(t=4.14-8.09, P=0.000) .Factor scores of somatization, compulsion, human relationship, depression, anxiety, phobia,and psychosis of case group were significantly higher than that of control group( u = 2. 107 - 8. 811, P = 0. 000) . There were no statistical significances in the factor scores of hostility and crankiness between two groups( P＞ 0. 05 ). SCL-90 total score was positively correlated with the total score of neural functional defect in case group( r = 0. 806 - 0. 293, P ＜ 0.01 ).CONCLUSION: Mood disturbance, such as, depression, anxiety and phobia are common in convalescent stage of senile cerebral infarct, which might be related with the severity of neural functional defect.