Gündel H, Busch R, Ceballos-Baumann A, Seifert E
Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany.
J Neurol Neurosurg Psychiatry. 2007 Dec;78(12):1398-400. doi: 10.1136/jnnp.2007.121699. Epub 2007 Jul 5.
To study the prevalence of psychiatric comorbidity assessed by a structured clinical interview in patients with spasmodic dysphonia (SD) compared with patients suffering from vocal fold paralysis (VFP).
In 48 patients with SD and 27 patients with VFP, overall psychiatric comorbidity was studied prospectively using the Structured Clinical Interview for DSM-IV Axis I disorders. Physical disability and psychometric variables were assessed with standardised self-rating questionnaires.
41.7% of SD subjects and 19.5% of the control group met DSM-IV clinical criteria for current psychiatric comorbidity (p<0.05). Significant predictors of psychiatric comorbidity in SD were severity of voice impairment and subjective assessment of "satisfaction with health". As a limitation, the severity of voice impairment in patients with SD was nearly twice as high, and their illness had lasted nearly twice as long.
We found a high prevalence of psychiatric comorbidity in patients with SD. The significant correlation between current psychiatric comorbidity and the extent of voice pathology may point to an especially strong interaction between somatic and psychiatric complaints in SD.
通过结构化临床访谈研究痉挛性发声障碍（SD）患者与声带麻痹（VFP）患者精神共病的患病率，并进行比较。
对48例SD患者和27例VFP患者，采用针对《精神疾病诊断与统计手册》第四版（DSM-IV）轴I障碍的结构化临床访谈对总体精神共病进行前瞻性研究。使用标准化自评问卷评估身体残疾和心理测量变量。
41.7%的SD受试者和19.5%的对照组符合DSM-IV当前精神共病的临床标准（p<0.05）。SD患者精神共病的显著预测因素是嗓音障碍的严重程度和“对健康的满意度”主观评估。作为一个局限性，SD患者的嗓音障碍严重程度几乎高出一倍，且其病程几乎长一倍。
我们发现SD患者中精神共病的患病率很高。当前精神共病与嗓音病理学程度之间的显著相关性可能表明SD患者躯体和精神症状之间存在特别强烈的相互作用。
