疑病症的临床及认知功能特点研究.docxVIP

疑病症的临床及认知功能特点研究 　　[摘要] 目的 探讨疑病症患者的临床特征及认知功能特点。 方法 选取XX年1～12月间在浙江大学医学院附属第一医院就诊的疑病症患者44例和健康对照者42例，使用汉密尔顿抑郁量表、汉密尔顿焦虑量表评定临床症状，使用精神分裂症认知功能成套测验共识版评定疑病症患者的认知功能。 结果 疑病症组HAMD、HAMA评分显著高于对照组。在MCCB测试中，疑病症组在注意/警觉性、工作记忆、词语学习、视觉学习、推理和问题解决、社会认知的分数及总体综合分数显著低于对照组。控制了年龄、性别、受教育年限影响因素以后，疑病症组HAMD评分、HAMA评分与注意/警觉性、工作记忆、词语学习、视觉学习、推理和问题解决、社会认知领域及总体综合分数成负相关。 结论 疑病症患者存在抑郁和焦虑情绪且有认知功能损害。　　[关键词] 疑病症；抑郁；焦虑；认知功能　　[中图分类号] R749 [文献标识码] B [文章编号] 1673--0086-04　　[Abstract] Objective To investigate the clinical characteristics and cognitive function of patients with hypochondriasis. Methods 44 patients with hypochondriasis and 42 healthy controls were selected from the First Affiliated Hospital of Zhejiang University from January to December XX. The clinical symptoms were assessed using the Hamilton’s depression scale items and the Hamilton’s anxiety scale， and the cognitive function was assessed by the MATRICS consensus cognitive battery. Results The scores of HAMD and HAMA in the hypochondriasis group were significantly higher than the control group. In the MCCB test， the scores of attention/alertness， working memory， vocabulary learning， visual learning， reasoning and problem solving， social cognition and overall score were significantly lower in the hypochondriasis group than those in the control group. HAMA score， HAMA score showed negative correlation with attention/alertness， working memory， vocabulary learning， visual learning， reasoning and problem solving， social cognition and overall composite scores after controlling for age， sex and education years. Conclusion Patients with hypochondriasis have depression， anxiety and cognitive impairment.　　[Key words] Hypochondriasis；Depression；Anxiety；Cognitive function　　疑病?Y是一种以担心或相信自身患有严重躯体疾病的持久性优势观念为主的神经症[1]。主要特征包括反复寻求身体检查、诊断、专业医生的保证及寻求来自朋友和家庭对其躯体症状和进一步深入检查的关心[2]。患者常常奔走于各大医院反复就诊及进行检查，其不但严重影响了患者正常的社会生活，且造成了医疗资源的巨大浪费[3]。国内报道疑病症的发病率在‰～‰[4-6]，国外报道初级保健门诊患者中疑病症平均发病率约为%[7]。XX年 Eric Rassin等[8]有关疑病症患者注意认知的研究发现，疑病症患者在信息处理加工过程中对躯体症状阳性信息的过度关注，而对阴性信息予以忽略，表明疑病症