前庭性眩晕疾病患者焦虑和抑郁状况研究

目的研究临床上常见的四种前庭性眩晕患者的焦虑/抑郁状况及其眩晕残障程度等相关因素并进行分析,为临床诊治四种前庭性眩晕提供依据。方法搜集确诊为前庭性眩晕的患者,分别为良性阵发性位置性眩晕(BPPV)、前庭性偏头痛(VM)、梅尼埃病(MD)及前庭神经炎(VN)四种疾病,记录患者的病程、持续时间等一般资料,完善耳科学检查并进行医院焦虑抑郁量表(HAD)、眩晕残障量表(DHI)测定。结果纳入前庭性眩晕患者121例,其中BPPV47例,VM31例,MD29例,VN14例,四组患者焦虑/抑郁阳性率分别为BPPV 31.9%、VM 71.0%、MD 75.9%、VN 42.9%;轻度、中度及重度眩晕残障程度分别为BPPV 58.9%、19.8%、21.3%,VM 19.4%、25.8%、54.8%,MD 6.9%、24.1%、69.0%,VN 38.6%、21.4%、40.0%。焦虑与抑郁评分之间线性相关(r=0.570,P<0.05);DHI与HAD评分之间线性相关(r=0.804;P<0.05)。结论前庭性眩晕患者存在不同程度的焦虑/抑郁,且焦虑和抑郁有一定的相关性;VM和MD患者焦虑/抑郁的发生率较高;VM、MD及VN患者眩晕残障程度高于BPPV患者。因此在临床上诊治前庭性眩晕疾病的时候要重视患者的焦虑/抑郁状态,特别是VM、MD患者,以便更好的治疗前庭性眩晕。

Anxiety and depression in patients with common types of vertigo

Objective To evaluate anxiety, depression, and disability in patients with vertigo and their underlying factors to provide a basis for clinical diagnosis and treatment of the four common types of vertigo. Methods Patients diagnosed with benign paroxysmal positional vertigo(BPPV), vestibular migraine(VM), Meniere's disease(MD), and vestibular neuritis(VN)were included in the study. Each patient's disease course, duration, relevant general information, and improvements in otological examination findings were evaluated. Anxiety, depression, and disability were also evaluated using the hospital anxiety and depression scale(HAD)and the dizziness disability scale(DHI). Results One hundred and twenty-one patients with vertigo were included; 47 had BPPV, 31 had VM, 29 had MD, and 14 had VN. The positive rates of anxiety and depression among patients with BPPV, VM, MD, and VN were 31.9%, 71.0%, 75.9%, and 42.9%, respectively. The proportions of mild, moderate, and severe cases of vertigo disability were: 58.9%, 19.8%, and 21.3%, respectively, for BPPV; 19.4%, 25.8%, and 54.8%, respectively, for VM; 6.9%, 24.1%, and 69.0% for, respectively, for MD; 38.6%, 21.4%, and 40.0%, respectively, for VN. There was a correlation between anxiety and depression scores(r=0.570, P<0.05)as well as DHI and HAD scores(r=0.804; P<0.05). Conclusion Anxiety and depression were manifested to varying degrees among the vertigo patients, but there was a correlation between them. VM and MD patients had a higher incidence of anxiety and depression, while VM, MD, and VN patients had more severe vertigo and disability than BPPV patients. Therefore, anxiety and depression should be considered during the diagnosis and treatment of vertigo, especially in patients with VM and MD, to facilitate diagnostic accuracy and effective treatment.