Negative prognostic factors for psychological conditions in patients with audiovestibular diseases.
Negative prognostic factors for psychological conditions in patients with audiovestibular diseases.
复制标题
DOI：
10.1016/j.anl.2016.02.006
复制
发表时间：
2016-12
期刊：
影响因子：
--
通讯作者：
Masaharu Sakagami;T. Kitahara;T. Okayasu;Akinori Yamashita;Akihito Hasukawa;I. Ota;T. Yamanaka
中科院分区：
文献类型：
--
作者：
Masaharu Sakagami;T. Kitahara;T. Okayasu;Akinori Yamashita;Akihito Hasukawa;I. Ota;T. Yamanaka
目的探讨影响听前庭疾病患者心理状态的因素。方法在12年的时间里，375例连续的听力前庭疾病患者被纳入本研究。疾病包括单侧（n= 174）和双侧（n= 51） meni<e:1>病、突发性耳聋伴眩晕（n= 70）和前庭神经炎（n= 80）。记录诊断、性别、年龄、病程、眩晕频率、持续性眼球震颤和同侧/对侧听力水平。所有患者急性眩晕缓解均采用康奈尔医学指数（III-IV分=神经症）和抑郁自评量表（> - 40分=抑郁）。结果双侧神经症和抑郁症分别占62.7%和82.4%，单侧神经症和抑郁症分别占32.7%和48.9%，突发性耳聋/眩晕分别占15.7%和38.6%，前庭神经炎分别占12.7%和31.3%。多变量logistic回归分析显示，meni<s:1>氏病病程较长（Oz 1.212， P= 0.021），继发患耳听力较差（Oz 1.131， P= 0.042）；突发性耳聋/眩晕伴持续性眼球震颤（Oz = 1.895；P= 0.005）；病程较长的前庭神经炎（Oz = 1.422， P= 0.019）和持续性眼震（Oz = 1.950， P= 0.0003）的精神疾病发生率明显高于病程较短、听力较好、无持续性眼震的前庭神经炎。结论精神障碍随单发眩晕、眩晕/听力丧失、反复症状和双侧病变而增加。对于持续性眼球震颤、病程长、继发患耳听力下降的患者，应谨慎制定治疗策略，避免出现心理障碍。
ObjectiveTo examine the backgrounds of patients with audiovestibular disease regarding what influences their psychological state.MethodsDuring a 12-year period, 375 successive patients with audiovestibular diseases were enrolled in this study. Diseases included unilateral (n= 174) and bilateral (n= 51) Menière's disease, sudden deafness with vertigo (n= 70), and vestibular neuritis (n= 80). Diagnosis, sex, age, duration of disease, vertigo frequency, persistent nystagmus, and ipsilateral/contralateral hearing levels were recorded. Cornell Medical Index (domains III–IV = neurosis) and Self-Rating Depression Scale (score > 40 = depression) were applied during acute vertigo remissions in all patients.ResultsNeurosis and depression, respectively, were diagnosed in 62.7% and 82.4% of bilateral Menière's, 32.7% and 48.9% of unilateral Menière's, 15.7% and 38.6% of sudden deafness/vertigo, and 12.7% and 31.3% of vestibular neuritis patients. Multivariable logistic regression analysis showed that Menière's disease with longer disease duration (Oz 1.212;P= 0.021) and worse hearing in the secondary affected ear (Oz 1.131;P= 0.042); sudden deafness/vertigo with persistent nystagmus (Oz 1.895;P= 0.005); and vestibular neuritis with longer disease duration (Oz 1.422;P= 0.019) and persistent nystagmus (Oz 1.950;P= 0.0003) had mental illness significantly more often than those with shorter-duration disease, better hearing and no persistent nystagmus.ConclusionMental disorder increased in accordance with solo vertigo, vertigo/hearing loss, repeated symptoms, and bilateral lesions. Treatment strategies should be carefully constructed for patients with persistent nystagmus, long disease duration, and hearing loss in the secondary affected ear to avoid psychological disorders.