Topçuoğlu Volkan, Bez Yasin, Sahin Biçer Duygu, Dib Hüssein, Kuşçu M Kemal, Yazgan Cağri, Ince Günal Dilek, Göktepe Esat
Marmara U Tip Fak., Psikiyatri AD., Istanbul.
Turk Psikiyatri Derg. 2006 Summer;17(2):93-100.
This study is aimed to determine the frequency of social phobia among a group of subjects with essential tremor, to compare subject groups with and without social phobia with regard to the level of social phobia and disability, and to study the effect of the severity of social phobia on disability in essential tremor.
45 subjects, diagnosed with essential tremor were included in the study, and their severity of tremor and essential tremor-related functional impairment were determined. Subjects were evaluated in 2 groups; those with a social phobia diagnosis and those without, as determined with the SCID-I interview. Additionally, the Liebowitz Social Anxiety Scale (LSAS) and the Sheehan Disability Scale (SDS) were administered to both groups and the findings were statistically compared.
Social phobia was observed in 19 subjects (42.2%) with essential tremor. While no difference was found between the groups in terms of tremor severity scores, the mean score of tremor-related functional disability in the social phobia group was found to be higher. Among subjects with social phobia, the mean fear and avoidance scores on LSAS were higher, whereas social lives and leisure activities of the same group were observed to have been affected more, according to SDS scores. Social avoidance and tremor severity were predictive for the difference on SDS. A significant and positive correlation between fear and avoidance, and disability in the group with social phobia was established.
It was concluded that essential tremor patients diagnosed with social phobia demonstrated higher social anxiety and disability compared to those without social phobia, and that social avoidance contributed to disability. Identifying social phobia in essential tremor patients and diagnosing these patients with social phobia, contrary to DSM's restrictive approach, would be appropriate and beneficial in terms of providing sufficient treatment.
本研究旨在确定一组特发性震颤患者中社交恐惧症的发生率,比较有和没有社交恐惧症的患者组在社交恐惧症水平和残疾程度方面的差异,并研究社交恐惧症严重程度对特发性震颤患者残疾的影响。
45名被诊断为特发性震颤的患者纳入本研究,确定其震颤严重程度和与特发性震颤相关的功能损害。根据SCID-I访谈确定,将患者分为两组进行评估:有社交恐惧症诊断的患者和没有社交恐惧症诊断的患者。此外,对两组患者均进行莱博维茨社交焦虑量表(LSAS)和希恩残疾量表(SDS)评估,并对结果进行统计学比较。
在45名特发性震颤患者中,有19名(42.2%)存在社交恐惧症。两组在震颤严重程度评分方面没有差异,但社交恐惧症组的震颤相关功能残疾平均评分更高。在有社交恐惧症的患者中,LSAS的恐惧和回避平均评分更高,而根据SDS评分,同一组患者的社交生活和休闲活动受到的影响更大。社交回避和震颤严重程度可预测SDS评分的差异。社交恐惧症组的恐惧与回避和残疾之间存在显著正相关。
得出的结论是,与没有社交恐惧症的特发性震颤患者相比,被诊断为社交恐惧症的特发性震颤患者表现出更高的社交焦虑和残疾程度,并且社交回避导致了残疾。与《精神疾病诊断与统计手册》(DSM)的限制性方法相反,识别特发性震颤患者中的社交恐惧症并对这些患者进行社交恐惧症诊断,在提供充分治疗方面将是合适且有益的。