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耳鸣困扰的预测因素及机制——一项纵向分析

[Predictors and mechanisms of tinnitus distress - a longitudinal analysis].

作者信息

Olderog M, Langenbach M, Michel O, Brusis T, Köhle K

机构信息

Klinik und Poliklinik für Psychosomatik und Psychotherapie, Universitätsklinikum Köln, Germany.

出版信息

Laryngorhinootologie. 2004 Jan;83(1):5-13. doi: 10.1055/s-2004-814235.

Abstract

BACKGROUND

The available cross-sectional and retrospective evidence does not provide a clear answer to the question whether the multiple psychological problems and disturbances found in patients with chronic decompensated tinnitus are cause or consequence of the tinnitus. The present research took a longitudinal approach to examine this question.

METHOD

Psychopathological symptoms, personality, socio-demographical variables and otological features were assessed in 48 patients which had suffered from tinnitus for a period of no longer than 4 weeks. Six months after first assessment 92 % of the original sample (n = 44) were re-examined. 34 of these patients displayed chronic tinnitus. Univariate and multiple regression analyses were conducted in order to identify variables at first assessment which predicted tinnitus distress at second assessment for the 34 patients with chronic tinnitus.

RESULTS

Tinnitus attributed sleep disturbance, anxiousness, and life satisfaction, each assessed at first investigation, independently predicted tinnitus distress at second assessment six months later. These three variables together predicted 56 % of the variance of tinnitus distress at second assessment.

CONCLUSIONS

Our results support the model that the symptom tinnitus may develop on the basis of an enhanced psychophysiological tension and become a condensational core of preexisting psychological distress as a facilitatory process. Our results suggest that early psychotherapeutic interventions in patients at risk may prevent decompensation.

摘要

背景

现有的横断面研究和回顾性研究证据并未明确回答慢性失代偿性耳鸣患者中发现的多种心理问题和障碍是耳鸣的原因还是结果这一问题。本研究采用纵向研究方法来探讨这个问题。

方法

对48名耳鸣时间不超过4周的患者进行了心理病理症状、人格、社会人口统计学变量和耳科特征评估。首次评估六个月后,对原始样本的92%(n = 44)进行了重新检查。其中34名患者表现为慢性耳鸣。进行了单因素和多元回归分析,以确定首次评估时能够预测34名慢性耳鸣患者第二次评估时耳鸣痛苦程度的变量。

结果

首次调查时评估的耳鸣导致的睡眠障碍、焦虑和生活满意度,均独立预测了六个月后第二次评估时的耳鸣痛苦程度。这三个变量共同预测了第二次评估时耳鸣痛苦程度方差的56%。

结论

我们的研究结果支持这样一种模型,即耳鸣症状可能在心理生理紧张加剧的基础上发展,并作为一个促进过程成为先前存在的心理困扰的凝聚核心。我们的研究结果表明,对有风险的患者进行早期心理治疗干预可能预防失代偿。

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