成人癫痫患者心理健康状况及影响因素的相关研究

发布时间：2018-05-17 08:35

本文选题：癫痫 + 心理健康　；参考：《昆明医科大学》2014年硕士论文

【摘要】：目的探讨癫痫患者的心理健康状况及人格特点,寻找影响癫痫患者心理健康的相关因素,引起临床医生对癫痫患者心理健康的重视,为临床医生采取综合干预措施改善癫痫患者的身心健康提供依据。方法 2012年3月至2013年12月于昆明医科大学第一附属医院神经内科门诊及住院部共收集75例隐源性癫痫患者。对这些患者进行一般资料、详细病史采集,应用90项症状自评量表(90Symptom Check list, SCL-90)、中国版艾森克人格问卷(Eysenck Personality Questionnaire-Chinese edition, EPQ)进行心理健康和人格特征评定。资料情况：75例入组的癫痫患者中,男性35例,女性41例,年龄17-45岁,平均年龄29.24±7.29岁：发作类型：全面强直阵挛发作38例,部分性发作37例,其中包括复杂部分性发作20例,复杂部分性发作继发全面性发作10例,部分运动性发作3例,部分感觉性发作4例；发作频率：≤3次/平均每3月38例,3次／平均每3月37例；病程分类：≤2年35例,2年40例。所采集的数据用SPSS17.0统计软件包进行处理分析,采用单样本与总体均数t检验、两独立样本t检验、线性相关及多元线性逐步回归分析,P0.05为有统计学意义。结果 SCL-90结果显示,75例隐源性癫痫患者除强迫因子分外,SCL-90总分、总均分、躯体化、人际关系敏感、焦虑、抑郁、敌对、恐怖、偏执、精神病性等因子分显著高于中国常模(P0.05)。病程2年的患者与病程≤2年的患者相比,前者的SCL-90总分、躯体化、强迫、人际关系敏感、焦虑、抑郁、敌对、恐怖、偏执等因子分显著高于后者(P0.05)；发作频率3次/3月的患者与发作频率≤3次/3月的患者相比,前者的SCL-90总分、躯体化、强迫、人际关系敏感、焦虑、抑郁、恐怖、偏执、敌对、精神病性等因子分显著高于后者(P0.05)；发作类型为全面强直-阵挛发作的癫痫患者与部分性发作的癫痫患者相比,两者的SCL-90总分、各因子分无显著性差异(P0.05)；男性癫痫患者与女性癫痫患者比较,女性患者的躯体化、抑郁、焦虑等因子分比男性患者显著增高(P0.05)；而男性患者的人际关系敏感、强迫等因子分显著高于女性患者(P0.05),同时SCL-90总分、敌对、恐怖、偏执、精神病性等因子分男性患者高于女性患者,但差异不显著(P0.05)。癫痫患者的人格特征为内向倾向型,情绪不稳定性及精神质倾向。癫痫患者的SCL-90总分、各因子分与艾森克人格(EPQ)的精神质(P)、神经质(N)维度得分呈显著正相关,相关系数(r)在0.60-0.93之间；与内外向(E)维度得分呈显著负相关,相关系数在0.57-0.90之间。艾森克人格(EPQ)的神经质(N)、内外向(E)、精神质(P)三个人格维度对SCL-90总分均有显著地预测作用,其中神经质的预测作用最大,其次为内外向、精神质。结论癫痫患者心理健康水平较正常人群差,容易出现躯体化、强迫、人际关系敏感、焦虑、抑郁、敌对、恐怖、偏执、病理性思维等广泛心理障碍。癫痫患者心理健康水平与癫痫病情(病程、发作频率)、性别及个性特点等多种因素有关,可以从以上多方面给予综合干预措施改善癫痫患者的心理健康状况。
[Abstract]:objective
To explore the psychological health status and personality characteristics of epileptic patients, to find the related factors that affect the mental health of the epileptic patients, cause the clinicians to pay attention to the mental health of the epileptic patients, and provide the basis for the clinicians to take comprehensive intervention measures to improve the physical and mental health of the epileptic patients.
Method
75 cases of cryptogenic patients were collected from the Department of Neurology and inpatient department of the First Affiliated Hospital of Kunming Medical University from March 2012 to December 2013. General information, detailed history collection, 90 symptom checklist (90Symptom Check list, SCL-90), and Chinese version of Eysenck Personality Questionnaire (Eysenck Personality Ques) were collected. Tionnaire-Chinese edition, EPQ) psychological health and personality characteristics assessment. Data: 75 cases of epileptic patients, 35 men, 41 women, age 17-45 years, average age 29.24 7.29 years old: seizure type: total tonic clonic seizures 38 cases, 37 cases of partial seizures, including complex partial episodes of 20 cases, complex Department There were 10 cases of secondary episodes secondary, 3 cases of partial motor attack and 4 cases of partial sensory seizures, attack frequency: 3 times / average 38 cases per March, 3 / average 37 cases per March; course classification: 2 years 35 cases, 2 years 40 cases. The data collected were processed and analyzed with SPSS17.0 statistical software package, using single sample and total average average number of t tests. Two independent samples t test, linear correlation and multiple linear stepwise regression analysis showed that P0.05 was statistically significant.
Result
SCL-90 results showed that 75 patients with cryptogenic epilepsy were significantly higher than the Chinese norm (P0.05), except for the SCL-90 total score, total score, total score, somatization, interpersonal sensitivity, anxiety, depression, hostility, terror, paranoia and psychosis (P0.05). The total score, somatization, and compulsion of the former 2 years were compared with those of the patients with the course of the disease less than 2 years. The factors such as interpersonal sensitivity, anxiety, depression, hostility, terror and paranoia were significantly higher than those of the latter (P0.05); patients with frequency of 3 /3 months of seizures were significantly higher than those of the former with the total score of SCL-90, somatization, compulsion, interpersonal sensitivity, anxiety, depression, terror, paranoia, hostility, and psychosis. Patients with generalized tonic clonic seizures were compared with those with partial seizures, and there was no significant difference in the total score of SCL-90 between the epileptic patients and those with partial seizures (P0.05), and the somatization, depression and anxiety of the female patients were significantly higher than those of the female patients (P0.05 The male patients were sensitive to the interpersonal relationship, and the factors of compulsion were significantly higher than those of the women (P0.05), while the total scores of SCL-90, hostility, terror, paranoia and psychosis were higher than those of the women, but the difference was not significant (P0.05).
The personality characteristics of epileptic patients were introversion, emotional instability and psychoticism. The total score of SCL-90 in epileptic patients was positively correlated with the mental quality (P) of Eysenck personality (EPQ), the score of neuroticism (N), correlation coefficient (R) between 0.60-0.93, and the score of internal and external (E) dimension, and the correlation coefficient. Between 0.57-0.90, the neuroticism (N) of Eysenck's personality (EPQ), internal and external (E), and three individual dimensions of psychoplasm (P) had a significant predictive effect on the total score of SCL-90, of which the neuroticism was the most predictive, followed by internal and external and psychoticism.
conclusion
The mental health level of epileptic patients is worse than that of the normal population, and it is easy to have extensive psychological barriers, such as somatization, compulsion, interpersonal sensitivity, anxiety, depression, hostility, terror, paranoia, and pathological thinking. The mental health of epileptic patients is related to various factors such as epilepsy (course of disease, frequency of seizures), sex and personality characteristics, which can be from the above Comprehensive intervention measures were adopted to improve the mental health status of epileptic patients.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R742.1

【参考文献】