Huang Heyin, Wang Yichen, Zhang Lanzhi, Zhang Qinxiu, Wu Xiaojuan, He Hengsheng
Department of Otolaryngology, Sichuan Integrative Medicine Hospital, Chengdu, China.
Department of Geriatric Orthopedics, Sichuan Province Orthopaedic Hospital, Chengdu, China.
JMIR Form Res. 2022 Nov 10;6(11):e37101. doi: 10.2196/37101.
The number of patients with allergic rhinitis (AR) has exceeded 500 million worldwide due to the unstable curative effect that can easily produce mental and psychological disorders. However, most of the relevant existing literature is one-on-one retrospective analyses or targeted meta-analyses of AR with psychological disorders like irritability, depression, and anxiety, while "multi-hospital + interdisciplinary" multiple regression analyses are scarce.
This study aims to precisely identify the psychological disorders of patients with AR who were diagnosed and treated in the five most renowned hospitals in Chengdu, China over the past 5 years using 10 classification methods so as to attract attention and care from otolaryngologists.
The Symptom Checklist 90 (SCL-90) was used to group and score the mental state of 827 strictly screened patients with AR according to 9 classification criteria. The scores were then compared within groups. Intergroup comparisons were made between the study group and the Chinese norm, and the positive factors for psychological disorders were extracted. Four symptoms in the study group, that is, nasal itching, sneezing, clear discharge, and nasal congestion, were scored on a visual analog scale. Partial correlation analysis was performed between the extracted positive factors for psychological disorders and the symptom scores by the multiple regression statistical method.
Among 827 patients, 124 (15%) had no mental health impairments, 176 (21.3%) had mild impairments, 474 (57.3%) had mild to moderate impairments, 41 (5%) had moderate to severe impairments, and 12 (1.4%) had severe impairments. The average score of the SCL-90 for all 827 patients was 2.64 (SD 0.25), which corresponded to mild to moderate mental health impairments. The 827 patients scored significantly higher for the 4 positive factors: depression, anxiety, psychosis, and other (sleep, diet). Depression was positively correlated with sneezing and clear discharge, anxiety was positively correlated with nasal itching and congestion, psychosis was positively correlated with nasal itching and sneezing, and other (sleep, diet) was positively correlated with clear discharge and nasal congestion.
Patients with AR have mild to moderate mental health impairments, with women and those with abnormal BMI, aged ≥45 years, with a monthly salary <¥5110 (US $700), with a disease duration <13 years, residing in urban areas, with a high school or above education, or who are indoor laborers being at high risk and requiring more care, follow-up, and comprehensive therapy from otolaryngologists.
由于过敏性鼻炎（AR）疗效不稳定，易引发精神心理障碍，全球AR患者数量已超过5亿。然而，现有相关文献大多是一对一的回顾性分析或针对AR与易怒、抑郁和焦虑等心理障碍的针对性荟萃分析，而“多医院+跨学科”的多元回归分析较少。
本研究旨在运用10种分类方法，精准识别过去5年在中国成都5家最知名医院确诊并接受治疗的AR患者的心理障碍，以引起耳鼻喉科医生的关注和重视。
采用症状自评量表90（SCL-90），根据9种分类标准对827例严格筛选的AR患者的心理状态进行分组和评分，然后进行组内比较。将研究组与中国常模进行组间比较，提取心理障碍的阳性因素。对研究组的鼻痒、打喷嚏、流清涕和鼻塞4种症状进行视觉模拟评分。采用多元回归统计方法对提取的心理障碍阳性因素与症状评分进行偏相关分析。
827例患者中，124例（15%）无心理健康损害，176例（21.3%）有轻度损害，474例（57.3%）有轻度至中度损害，41例（5%）有中度至重度损害，12例（1.4%）有重度损害。827例患者SCL-90的平均评分为2.64（标准差0.25），对应轻度至中度心理健康损害。827例患者在抑郁、焦虑、精神病性和其他（睡眠、饮食）4个阳性因子上得分显著更高。抑郁与打喷嚏和流清涕呈正相关，焦虑与鼻痒和鼻塞呈正相关，精神病性与鼻痒和打喷嚏呈正相关，其他（睡眠、饮食）与流清涕和鼻塞呈正相关。
AR患者存在轻度至中度心理健康损害，女性、BMI异常、年龄≥45岁、月工资<5110元（700美元）、病程<13年、居住在城市、高中及以上学历或为室内劳动者的患者风险较高，需要耳鼻喉科医生给予更多关注、随访和综合治疗。
