慢性偏头痛患者躯体化症状与焦虑、抑郁的横断面分析

Cross-sectional analysis of somatization symptoms, anxiety, and depression in patients with chronic migraineFU Zenghui, JIN Yan, LIN Zaihong, JIANG Yan, DU Shu, LIU Jing, ZHANG Guangping, LIU Yang, YU Huili

摘要:

目的：探讨慢性偏头痛(CM)患者躯体化症状与焦虑、抑郁状况,并分析其关系,为慢性偏头痛患者精神心理评估与干预提供借鉴。方法：收集2022年01月至2023年02月齐齐哈尔医学院附属第三医院就诊的278例CM患者。收集一般临床资料,采用躯体化症状自评量表(SSS)、广泛性焦虑障碍量表-7(GAD-7)、患者健康问卷-9(PHQ-9)、匹茨堡睡眠质量量表(PSQI)、疼痛数字评分法(NRS)和偏头痛失能程度量表(MIDAS)分别对研究对象躯体化症状、焦虑、抑郁、睡眠、头痛程度和失能程度进行评价。结果：150名CM患者SSS量表筛查呈阳性,阳性率为53.96%。与SSS阴性CM患者相比,SSS阳性CM患者教育年限[(9.95±2.28)年与(14.84±4.01)年,t=2.228,P＜0.012]、头痛程度评分[(3.89±0.93)分与(6.95±1.02)分,t=4.143,P=0.002]、头痛持续时间[(6.69±2.21)h与(19.73±6.10)h,t=4.892,P＜0.001]、发作频率[(4.75±1.63)次/d与(8.38±3.16)次/d,t=4.093,P=0.003]、头痛病程[(8.17±3.10)年与(15.56±4.73)年,t=4.441,P＜0.001]、失能程度评分[(3.12±0.83)分与(5.91±1.49)分,t=3.991,P=0.004]、焦虑评分[(2.87±0.94)分与(4.93±1.91)分,t=0.731,P=0.315]、抑郁评分[(3.15±1.79)分与(7.17±3.05)分,t=3.976,P＜0.001]和睡眠评分[(7.06±3.14)分与(12.50±3.20)分,t=1.381,P=0.091]较高。相关因素分析结果显示,头痛程度评分(P＜0.001)、头痛持续时间(P＝0.003)、发作频率(P＝0.003)、病程(P＝0.001)、失能程度评分(P＝0.004)、焦虑评分(P＜0.001)、抑郁评分(P＝0.003)和睡眠评分(P＝0.004)是CM患者躯体化症状的危险因素。结论：CM患者伴随躯体化症状较为普遍,头痛程度严重、头痛持续时间长、频繁的头痛发作频率、较长头痛病程、较高失能程度、焦虑、抑郁和睡眠差是CM患者发生躯体化症状的危险因素。

Abstract:

Objective: To explore the relationship between somatization symptoms, anxiety, and depression in patients with chronic migraine (CM), and to provide reference for psychosocial evaluation and intervention in patients with chronic migraine. Methods: From January 2022 to February 2023, 278 patients with CM were collected from the Third Affiliated Hospital of Qiqihar Medical College. General clinical data were collected and the somatization symptoms, anxiety, depression, sleep, headache, and disability of the study subjects were evaluated using the Somatization Symptom Checklist (SSS), Generalized Anxiety Disorder Scale-7 (GAD-7), Patient Health Questionnaire - 9 (PHQ-9), Pittsburgh Sleep Quality Inventory (PSQI), NRS, and Migraine Disability Scale (MIDAS). Results: 150 patients with CM were screened positive for SSS, with a positive rate of 53.96%. Compared with SSS negative CM patients, SSS positive CM patients had a number of years of education [(9.95 ± 2.28) years vs (14.84 ± 4.01) years, t=2.228, P<0.012], a headache severity score [(3.89 ± 0.93) vs (6.95 ± 1.02) points, t=4.143, P=0.002], a headache duration [(6.69 ± 2.21) hours vs (19.73 ± 6.10) hours, t=4.892, P<0.001], a seizure frequency [(4.75 ± 1.63) times/d vs (8.38 ± 3.16) times/d, t=4.093, P=0.003] Headache duration [(8.17 ± 3.10) years vs (15.56 ± 4.73) years, t=4.441, P<0.001], disability score [(3.12 ± 0.83) points vs (5.91 ± 1.49) points, t=3.991, P=0.004], anxiety score [(2.87 ± 0.94) points vs (4.93 ± 1.91) points, t=0.731, P=0.315] Depression scores [(3.15 ± 1.79) points vs (7.17 ± 3.05) points, t=3.976, P<0.001] and sleep scores [(7.06 ± 3.14) points vs (12.50 ± 3.20) points, t=1.381, P=0.091] were higher. Analysis of related factors showed that headache severity score (P<0.001), headache duration (P=0.003), attack frequency (P=0.003), course of disease (P=0.001), disability score (P=0.004), anxiety score (P<0.001), depression score (P=0.003), and sleep score (P=0.004) were risk factors for somatization symptoms in CM patients. Conclusion: Somatization symptoms are common in CM patients, and severe headache severity, long duration of headache, frequent frequency of headache attacks, longer duration of headache, higher degree of disability, anxiety, depression, and poor sleep are risk factors for the occurrence of somatization symptoms in CM patients.