本文選題：癲癇 + 心理健康　； 參考：《昆明醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的 探討癲癇患者的心理健康狀況及人格特點(diǎn),尋找影響癲癇患者心理健康的相關(guān)因素,引起臨床醫(yī)生對(duì)癲癇患者心理健康的重視,為臨床醫(yī)生采取綜合干預(yù)措施改善癲癇患者的身心健康提供依據(jù)。 方法 2012年3月至2013年12月于昆明醫(yī)科大學(xué)第一附屬醫(yī)院神經(jīng)內(nèi)科門診及住院部共收集75例隱源性癲癇患者。對(duì)這些患者進(jìn)行一般資料、詳細(xì)病史采集,應(yīng)用90項(xiàng)癥狀自評(píng)量表(90Symptom Check list, SCL-90)、中國(guó)版艾森克人格問(wèn)卷(Eysenck Personality Questionnaire-Chinese edition, EPQ)進(jìn)行心理健康和人格特征評(píng)定。資料情況：75例入組的癲癇患者中,男性35例,女性41例,年齡17-45歲,平均年齡29.24±7.29歲：發(fā)作類型：全面強(qiáng)直陣攣發(fā)作38例,部分性發(fā)作37例,其中包括復(fù)雜部分性發(fā)作20例,復(fù)雜部分性發(fā)作繼發(fā)全面性發(fā)作10例,部分運(yùn)動(dòng)性發(fā)作3例,部分感覺(jué)性發(fā)作4例；發(fā)作頻率：≤3次/平均每3月38例,3次／平均每3月37例；病程分類：≤2年35例,2年40例。所采集的數(shù)據(jù)用SPSS17.0統(tǒng)計(jì)軟件包進(jìn)行處理分析,采用單樣本與總體均數(shù)t檢驗(yàn)、兩獨(dú)立樣本t檢驗(yàn)、線性相關(guān)及多元線性逐步回歸分析,P0.05為有統(tǒng)計(jì)學(xué)意義。 結(jié)果 SCL-90結(jié)果顯示,75例隱源性癲癇患者除強(qiáng)迫因子分外,SCL-90總分、總均分、軀體化、人際關(guān)系敏感、焦慮、抑郁、敵對(duì)、恐怖、偏執(zhí)、精神病性等因子分顯著高于中國(guó)常模(P0.05)。病程2年的患者與病程≤2年的患者相比,前者的SCL-90總分、軀體化、強(qiáng)迫、人際關(guān)系敏感、焦慮、抑郁、敵對(duì)、恐怖、偏執(zhí)等因子分顯著高于后者(P0.05)；發(fā)作頻率3次/3月的患者與發(fā)作頻率≤3次/3月的患者相比,前者的SCL-90總分、軀體化、強(qiáng)迫、人際關(guān)系敏感、焦慮、抑郁、恐怖、偏執(zhí)、敵對(duì)、精神病性等因子分顯著高于后者(P0.05)；發(fā)作類型為全面強(qiáng)直-陣攣發(fā)作的癲癇患者與部分性發(fā)作的癲癇患者相比,兩者的SCL-90總分、各因子分無(wú)顯著性差異(P0.05)；男性癲癇患者與女性癲癇患者比較,女性患者的軀體化、抑郁、焦慮等因子分比男性患者顯著增高(P0.05)；而男性患者的人際關(guān)系敏感、強(qiáng)迫等因子分顯著高于女性患者(P0.05),同時(shí)SCL-90總分、敵對(duì)、恐怖、偏執(zhí)、精神病性等因子分男性患者高于女性患者,但差異不顯著(P0.05)。 癲癇患者的人格特征為內(nèi)向傾向型,情緒不穩(wěn)定性及精神質(zhì)傾向。癲癇患者的SCL-90總分、各因子分與艾森克人格(EPQ)的精神質(zhì)(P)、神經(jīng)質(zhì)(N)維度得分呈顯著正相關(guān),相關(guān)系數(shù)(r)在0.60-0.93之間；與內(nèi)外向(E)維度得分呈顯著負(fù)相關(guān),相關(guān)系數(shù)在0.57-0.90之間。艾森克人格(EPQ)的神經(jīng)質(zhì)(N)、內(nèi)外向(E)、精神質(zhì)(P)三個(gè)人格維度對(duì)SCL-90總分均有顯著地預(yù)測(cè)作用,其中神經(jīng)質(zhì)的預(yù)測(cè)作用最大,其次為內(nèi)外向、精神質(zhì)。 結(jié)論 癲癇患者心理健康水平較正常人群差,容易出現(xiàn)軀體化、強(qiáng)迫、人際關(guān)系敏感、焦慮、抑郁、敵對(duì)、恐怖、偏執(zhí)、病理性思維等廣泛心理障礙。癲癇患者心理健康水平與癲癇病情(病程、發(fā)作頻率)、性別及個(gè)性特點(diǎn)等多種因素有關(guān),可以從以上多方面給予綜合干預(yù)措施改善癲癇患者的心理健康狀況。
[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.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R742.1

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