Linzer M, Pontinen M, Gold D T, Divine G W, Felder A, Brooks W B
Department of Medicine, Duke University Medical Center, Durham, NC 27710.
J Clin Epidemiol. 1991;44(10):1037-43. doi: 10.1016/0895-4356(91)90005-t.
Physical and psychosocial function have rarely been assessed in syncope. We used two valid and reliable measures of health status, the Sickness Impact Profile (SIP) and the Symptom Checklist 90 (SCL-90-R), to assess functional impairment in 62 patients with recurrent syncope seen in a syncope specialty clinic. Mean total SIP scores were markedly elevated at 17 (SD = 14), indicating a level of impairment similar to severe rheumatoid arthritis and chronic low back pain. SIP psychosocial scores were significantly greater than SIP physical scores (20 vs 11, p less than 0.0001). SCL-90-R scores were also high, comparable to those of psychiatric inpatients. Somatization, anxiety and depression dimensions of the SCL-90-R were particularly elevated. SCL-90-R subscale scores were highly correlated with SIP psychosocial scores (all r greater than 0.4, and p less than 0.001). Neither age nor number of comorbid diseases correlated with measures of psychosocial function, suggesting that syncope itself causes psychosocial impairment. Although this was a referral population, these data suggest that function can be seriously impaired by syncope, that the degree of impairment is similar to that reported in other chronic diseases, and that syncope leads to significantly greater psychosocial than physical impairment.
很少有人对晕厥患者的身体和心理社会功能进行评估。我们使用了两种有效且可靠的健康状况测量方法，即疾病影响量表（SIP）和症状自评量表90（SCL - 90 - R），来评估在晕厥专科门诊就诊的62例复发性晕厥患者的功能损害情况。SIP总得分均值显著升高，为17分（标准差 = 14），表明其损害程度与严重类风湿性关节炎和慢性腰痛相似。SIP心理社会得分显著高于SIP身体得分（20分对11分，p < 0.0001）。SCL - 90 - R得分也很高，与精神科住院患者相当。SCL - 90 - R的躯体化、焦虑和抑郁维度尤其升高。SCL - 90 - R子量表得分与SIP心理社会得分高度相关（所有r > 0.4，且p < 0.001）。年龄和共病疾病数量均与心理社会功能测量指标无关，这表明晕厥本身会导致心理社会损害。尽管这是一个转诊人群，但这些数据表明晕厥会严重损害功能，其损害程度与其他慢性疾病报告的情况相似，并且晕厥导致的心理社会损害明显大于身体损害。
