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心身症状还是过敏症状?药物不耐受患者躯体化程度较高。

Psychosomatic or allergic symptoms? High levels for somatization in patients with drug intolerance.

机构信息

Department of Dermatology, University Hospital Mannheim, Mannheim, Germany.

出版信息

J Dermatol. 2011 Oct;38(10):959-65. doi: 10.1111/j.1346-8138.2011.01249.x. Epub 2011 Jul 18.

DOI:10.1111/j.1346-8138.2011.01249.x
PMID:21767296
Abstract

Patients with dermatological diseases often have associated psychological problems. For patients with allergic diseases, only a few publications have focused on psychological aspects. The objective of this study was to assess the psychometric profile, including somatization, depression, anxiety and health-related quality of life (HRQoL), of patients suffering from drug intolerance or hymenoptera venom allergies. In a prospective cohort study design, patients who were admitted to hospital for a challenge test for an alternative drug (n = 49, 24.5% men) or for induction of desensitization therapy with hymenoptera venom (n = 58, 37.9% men) were included. Psychometric screening questionnaires focusing on somatization (Symptom Check List), depression and anxiety (Hospital Anxiety Depression Scale), and also on HRQoL (Short Form questionnaire) were assessed. The scores were compared with population scores and between the two groups. Both groups had significantly higher somatization scores (P ≤ 0.003) than the normal population, and the challenge-test group had lower HRQoL than the normal population. Between-group analysis revealed significantly higher somatization scores in the challenge-test group (P = 0.011) and more impaired HRQoL (physical health domain P < 0.001). Anxiety/depression scores were not significantly different from those of the normal population, or between groups, although abnormally high scores for anxiety were frequent (18% and 12% for the challenge-test and allergy groups, respectively). Somatization, reduced HRQoL and anxiety seem to be part of the symptoms of patients with allergic diseases, especially for patients with drug intolerance. Standardized questionnaires could help to discover patients who may need psychological support. This may help to improve the patients' symptoms and quality of life.

摘要

皮肤病患者常伴有心理问题。对于过敏患者,仅有少数文献关注其心理方面。本研究旨在评估药物不耐受或蜂毒液过敏患者的心理计量特征,包括躯体化、抑郁、焦虑和健康相关生活质量(HRQoL)。在一项前瞻性队列研究设计中,纳入因替代药物激发试验(n=49,男性占 24.5%)或因蜂毒液脱敏治疗而入院的患者(n=58,男性占 37.9%)。评估了躯体化(症状检查表)、抑郁和焦虑(医院焦虑抑郁量表)以及 HRQoL(简短问卷)的心理计量筛查问卷。将评分与人群评分和两组间进行比较。两组的躯体化评分均显著高于正常人群(P≤0.003),激发试验组的 HRQoL 低于正常人群。组间分析显示激发试验组的躯体化评分显著升高(P=0.011),HRQoL 受损更严重(身体状况领域 P<0.001)。焦虑/抑郁评分与正常人群或两组间无显著差异,但焦虑评分异常高的情况较常见(激发试验组和过敏组分别为 18%和 12%)。躯体化、HRQoL 降低和焦虑似乎是过敏患者症状的一部分,尤其是药物不耐受患者。标准化问卷可帮助发现可能需要心理支持的患者。这可能有助于改善患者的症状和生活质量。

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