Manu P, Affleck G, Tennen H, Morse P A, Escobar J I
Department of Psychiatry, Long Island Jewish Medical Center, New Hyde Park, N.Y., USA.
Psychother Psychosom. 1996 Mar-Apr;65(2):76-81. doi: 10.1159/000289050.
To determine how hypochondriacal symptoms influence the quality-of-life outcomes of patients with a chief complaint of chronic fatigue.
Cross-sectional cohort study of a consecutive sample of 71 patients (mean duration of fatigue of 4.1 years). Forty-eight (68%) patients met criteria for current major depression and 32 (45%) met criteria for chronic fatigue syndrome (CFS). All patients received a comprehensive medical and psychiatric evaluation. Quality-of-life and physical, depressive and hypochondriacal symptom scores were assessed through reliable self-report questionnaires and a structured interview. A path model expressing the relation between predictor variables (hypochondriasis and depression), intervening variables (physical symptoms) and quality of life was postulated and evaluated using structural equation methods.
The paths linking hypochondriasis with physical symptoms and mental health and the path connecting physical symptoms and quality of life were each statistically significant. The model applied especially well to patients who fulfilled CFS criteria.
The quality of life of chronic fatigue patients correlates with the severity of their physical symptoms and their hypochondriacal disposition toward illness.
确定疑病症状如何影响以慢性疲劳为主诉的患者的生活质量结局。
对连续选取的71例患者（疲劳平均持续时间为4.1年）进行横断面队列研究。48例（68%）患者符合当前重度抑郁症标准，32例（45%）符合慢性疲劳综合征（CFS）标准。所有患者均接受了全面的医学和精神科评估。通过可靠的自我报告问卷和结构化访谈评估生活质量以及身体、抑郁和疑病症状评分。使用结构方程方法假设并评估了一个表达预测变量（疑病症和抑郁症）、中介变量（身体症状）与生活质量之间关系的路径模型。
连接疑病症与身体症状及心理健康的路径以及连接身体症状与生活质量的路径均具有统计学意义。该模型对符合CFS标准的患者尤其适用。
慢性疲劳患者的生活质量与其身体症状的严重程度以及对疾病的疑病倾向相关。
