Anxiety and depression state among patients with different type of vertigo and dizziness
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摘要: 目的 评估不同病因眩晕患者焦虑、抑郁状态, 并分析其可能原因。方法 收集住院治疗的559例眩晕患者的临床资料, 并完善焦虑/抑郁自评量表。结果 559例患者中前庭性偏头痛(VM)94例、梅尼埃病(MD)86例、良性阵发性位置性眩晕(BPPV)78例、突发性聋伴眩晕77例、病因不明74例、前庭神经炎58例、良性复发性眩晕(BRV)57例、持续性姿势知觉性头晕(PPPD)35例。焦虑状态总人数241例(43.11%), 其中最高的为病因不明者(64.86%), 其次为VM(63.83%)、MD(55.81%)、PPPD(48.57%), BRV(47.37%)。抑郁状态总人数63例(11.27%), 其中最高的为病因不明者(25.68%), 其次为PPPD(17.14%)、VM(14.89%)、BRV(14.04%)、MD(12.79%)。采用多个独立样本非参数检验法检验各组眩晕患者SAS及SDS评分值, 结果显示各组均存在显著性差异。根据眩晕病程长短将所有患者分为 < 2个月组、2个月~2年组和>2年组。焦虑状态患病率最高的是>2年组(58.56%), 其次为2个月~2年组(54.75%), 显著高于 < 2个月组(17.30%), 前两组间经χ2检验, 差异无统计学意义(P>0.05)。抑郁状态患病率最高的是>2年组(32.43%), 其次为2个月~2年组(10.27%), 显著高于 < 2个月组(0%), 3组间经χ2检验, 差异均有统计学意义(P < 0.01)。结论 常见眩晕患者中, 焦虑状态较抑郁状态更易出现。VM、MD、PPPD、BRV较易出现焦虑及抑郁状态。Abstract: Objective To assess the status of anxiety and depression among patients with different type of vertigo and dizziness, and to figure out the possible reason.Methods The data of the patients with vertigo from November 2017 to June 2020 were reviewed, and their status of anxiety and depression were assessed using self-rating anxiety scale(SAS) and self-rating depression scale(SDS).Results A total of 559 patients with vertigo were enrolled, including 94 cases for vestibular migraine (VM), 86 cases for Meniere disease (MD), 78 cases for benign paroxysmal positional vertigo (BPPV), 77 cases for sudden hearing loss(SHL) with vertigo, 74 cases for no definite diagnosis, 58 cases for vestibular neuritis (VN), 57 cases for benign recurrent vertigo (BRV) and 35 cases for persistent postural-perceptual dizziness (PPPD).The incidence of anxiety is 43.11%(no definite diagnosis=64.86%, VM=63.83%, MD=55.81%, PPPD=48.57%, BRV=47.37%), and the incidence of depression is 11.27% (no definite diagnosis=25.68%, PPPD=17.14%, VM=14.89%, BRV=14.04%, MD=12.79%). Kruskal-Wallis test was used to analyze SAS and SDS scores of patients with vertigo. The results showed that there were significant differences in each group. All patients were divided into 3 groups according to the duration of vertigo. The anxiety incidence of >2 years group was highest(58.56%), and the second one was 2 months to 2 years group(54.75%). There was no statistically significant difference between 2 groups by χ2 test(P>0.05). But both of them were significantly higher than the < 2 months group(17.30%). The depression incidence of >2 years group was highest(32.43%), the second one was 2 months to 2 years group(10.27%), and the lowest one was < 2 months group(0%). χ2 test(P < 0.01) showed statistically significant differences among these three groups.Conclusion Anxiety is more common among patients with vertigo than depression, and the patients who suffer from VM, MD, PPPD or BRV have significantly higher rates of psychiatric comorbidity.
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Key words:
- vertigo /
- anxiety /
- depression
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表 1 各病因眩晕患者SAS、SDS评分
病因 焦虑状态/例(%) 抑郁状态/例(%) SAS/分 SDS/分 病因不明 48(64.86) 19(25.68) 52.45±8.34 46.04±9.27 VM 60(63.83) 14(14.89) 50.60±11.43 43.80±8.74 MD 48(55.81) 11(12.79) 48.01±11.54 40.88±8.78 BPPV 17(21.79) 2(2.56) 39.31±8.88 32.09±6.00 SHL 14(18.18) 3(3.90) 34.71±10.03 34.66±7.45 VN 10(17.24) 0(0.00) 36.5±8.98 31.98±7.03 BRV 27(47.37) 8(14.04) 45.21±11.87 41.74±9.62 PPPD 17(48.57) 6(17.14) 47.26±11.20 43.49±9.15 
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表 2 不同病程的患者焦虑及抑郁状态患病率
例(%) 组别 例数 焦虑状态 抑郁状态 < 2个月组 185(33.09) 32(17.30) 0(0.00) 2个月~2年组 263(47.05) 144(54.75) 27(10.27) >2年组 111(19.86) 65(58.56) 36(32.43) 合计 559(100.00) 241(43.11) 63(11.27)
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表 3 根据眩晕发作频率分组比较
例(%) 组别 例数 焦虑状态 抑郁状态 一天数次组 38(10.16) 38(100.00) 33(86.84) 数天一次组 107(28.61) 82(76.64) 18(16.82) 数月一次组 229(61.23) 89(38.86) 12(5.24) 合计 374(100.00) 209(55.88) 63(16.84)
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