Air Mary Elizabeth
Hospital for Special Surgery, Department of Physiatry, 535 East 70th Street, New York, New York, USA.
J Dance Med Sci. 2013 Sep;17(3):115-25. doi: 10.12678/1089-313x.17.3.115.
The purpose of this study was to investigate the incidence and magnitude of clinically significant psychological symptoms among outpatient injured dancers presenting for musculoskeletal issues and to identify features of "at risk" dancer-patients who might require additional psychological support when injured. The Brief Symptom Inventory® (BSI), a highly reliable and valid screening tool for psychological distress, was administered to first- and last-visit injured dancers at an orthopedic clinic in the Netherlands from February to May 2008. In all, 153 BSI surveys were completed, including 82 among first-visit patients and 71 among end-treatment patients. Scores were examined for the influence of age, gender, dance level, style, pain, perceived level of artistic compromise, and anatomic location of injury. Dancers' scores were compared to normative values for adult non-psychiatric patient community members. Ninety-two dancers (60.1%) met requirements for clinical referral to a psychologist or psychiatrist, having scored two or more standard deviations (SD) above the norm in at least one of nine psychopathological symptoms. Across first- and last-visit groups, dancers met referral criteria for an average of four psychopathological symptoms. First-visit dancers demonstrated higher distress than the general population on 90% of BSI dimensional symptoms and last-visit dancers on 50%. On the Global Symptom Index, a summary score for overall distress and the best measure of psychological discomfort, 46.6% of dancers demonstrated "above average" distress (≥ 1 SD) compared to the general population, and 19.6% demonstrated "high" (≥ 2 SD) or "very high" (≥ 2.5 SD) distress. Compared to academy level pre-professional students, professionals showed reduction in BSI scores on somatic, cognitive, interpersonal sensitivity, anxious, hostile, phobic, and global scores following resolution of injury, particularly among those greater than 25 years of age. Students and professionals less than 25 years of age demonstrated little change in scores from the initial visit to the end of treatment. In addition, students worsened in somatization and depression domains over time, suggesting perseverative or brooding behavior and poor coping skills. Amateurs overall scored average or below average on the BSI compared to the general population at both time points. It is concluded that healthcare providers should be made aware that outpatient injured dancers presenting for musculoskeletal assessment may additionally have high levels of psychological distress, and this may warrant formal evaluation by a mental health professional.
本研究的目的是调查因肌肉骨骼问题就诊的门诊受伤舞者中具有临床意义的心理症状的发生率和严重程度，并确定“高危”舞者患者的特征，这些患者在受伤时可能需要额外的心理支持。2008年2月至5月，在荷兰一家骨科诊所，对首次就诊和末次就诊的受伤舞者使用了症状自评量表（BSI），这是一种用于筛查心理困扰的高度可靠且有效的工具。总共完成了153份BSI调查问卷，其中首次就诊患者82份，治疗结束患者71份。研究考察了年龄、性别、舞蹈水平、风格、疼痛程度、艺术表现力受损程度以及损伤解剖位置对得分的影响。将舞者的得分与成年非精神科患者群体的常模值进行比较。92名舞者（60.1%）符合转介至心理学家或精神科医生进行临床评估的标准，在九种精神病理症状中的至少一种上得分高于常模两个或更多标准差（SD）。在首次就诊和末次就诊组中，舞者平均符合四种精神病理症状的转介标准。首次就诊的舞者在90%的BSI维度症状上表现出比一般人群更高的困扰，末次就诊的舞者则为50%。在全球症状指数（用于总体困扰的综合得分以及心理不适的最佳衡量指标）上，46.6%的舞者表现出“高于平均水平”的困扰（≥1 SD），与一般人群相比，19.6%表现出“高”（≥2 SD）或“非常高”（≥2.5 SD）的困扰。与学院水平的专业预科学生相比，专业舞者在受伤恢复后，在躯体、认知、人际敏感、焦虑、敌对、恐惧和全球得分方面的BSI得分有所降低，尤其是年龄大于25岁的舞者。25岁以下的学生和专业舞者从首次就诊到治疗结束得分变化不大。此外，随着时间推移，学生在躯体化和抑郁领域的得分变差，表明存在持续或沉思行为以及不良的应对技巧。在两个时间点，与一般人群相比，业余舞者在BSI上的总体得分均为平均水平或低于平均水平。研究得出结论，医疗保健提供者应意识到，因肌肉骨骼问题就诊的门诊受伤舞者可能还存在高水平的心理困扰，这可能需要心理健康专业人员进行正式评估。
