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研究背景发作性运动诱发性运动障碍是一组由突然动作诱发的非随意性运动障碍性疾病,表现为反复发作的短暂性肌张力障碍或舞蹈样动作。本研究旨在调查中国发作性运动诱发性运动障碍患者社会心理学特点,并探讨发作性运动诱发性运动障碍及其相关影响因素之间的关系。方法采用自行设计的发作性运动诱发性运动障碍调查问卷对188例发作性运动诱发性运动障碍患者进行调查,包括症状自测量表(SCL-90)和世界卫生组织生活质量量表(WHOQoL-100)两部分,分别评价精神心理症状和生活质量,Pearson相关分析和偏相关分析以及多重回归分析评价发作性运动诱发性运动障碍生活质量及其相关影响因素之间的关系。结果 188例患者最终回收有效问卷120份,与中国人群常模数据相比,发作性运动诱发性运动障碍患者SCL-90量表中文版之躯体化(P=0.000)、强迫症状(P=0.000)、人际关系敏感(P=0.000)、抑郁症状(P=0.000)、焦虑症状(P=0.000)、敌对(P=0.000)、恐怖(P=0.000)、偏执(P=0.000)和精神病性症状(P=0.000)以及总症状指数均增加,WHOQoL-100量表中文版之总体生活质量(P=0.000)和生理(P=0.000)、心理(P=0.000)、独立性(P=0.000)、社会关系(P=0.000)评分均降低。Pearson相关分析和偏相关分析显示,发作类型之复杂型发作性运动诱发性运动障碍和自愈倾向与发作性运动诱发性运动障碍生活质量呈正相关(P=0.016,0.000),躯体化、强迫症状、人际关系敏感、抑郁症状、焦虑症状、敌对、恐怖、偏执、精神病性症状等精神心理症状与发作性运动诱发性运动障碍生活质量呈负相关(均P=0.000)。多重回归分析显示,自愈倾向(P=0.024)和抑郁症状(P=0.000)与发作性运动诱发性运动障碍生活质量显著相关,其影响程度依次为自愈倾向(R~2=0.423)和抑郁症状(R~2=0.398)。结论发作性运动诱发性运动障碍患者普遍存在精神心理负担,且在生理、心理、独立性和社会关系方面生活质量较差。临床医师应对发作性运动诱发性运动障碍患者可能存在的精神心理症状进行及时评价和必要心理干预,尤其应注意抑郁症状评分较高且无自愈倾向的患者。
Background The episodic motor-induced dyskinesia is a group of involuntary dyskinesia induced by sudden movements, manifested as recurrent episodes of transient dystonia or dance-like movements. The purpose of this study was to investigate the psychosocial characteristics of patients with episodic motor-induced dyskinesia in China and to explore the relationship between episodic motor-induced dyskinesia and its associated influencing factors. Methods A total of 188 patients with episodic motor-induced dyskinesia were investigated by using a self-designed questionnaire of episodic motor-induced dyskinesia, including the SCL-90 and WHOQOL-100 ) Were used to evaluate the relationship between psychotic symptoms and quality of life, Pearson correlation analysis and partial correlation analysis, and multiple regression analysis to evaluate the quality of life and the related factors of stroke-induced dyskinesia. Results A total of 120 valid questionnaires were collected from 188 patients. Compared with the Chinese population, the Chinese version of SCL-90 was found to be somatic (P = 0.000) and obsessive-compulsive symptoms (P = 0.000 , Interpersonal sensitivity (P = 0.000), depressive symptoms (P = 0.000), anxiety symptoms (P = 0.000), hostility (P = 0.000), horror (P = 0.000), paranoid (P = 0.000) and psychotic Symptoms (P = 0.000) and overall symptom index increased. The overall quality of life (P = 0.000), psychology (P = 0.000), independence ), Social relations (P = 0.000) scored lower. Pearson correlation analysis and partial correlation analysis showed that the seizure type of complex episodic exercise-induced dyskinesia and self-healing tendency was positively correlated with the quality of life-induced exercise-induced dyskinesia (P = 0.016,0.000), somatization, obsessive-compulsive symptoms , Interpersonal sensitivity, depressive symptoms, anxiety symptoms, hostility, horror, paranoid, psychotic symptoms and other psychiatric symptoms were negatively correlated with the quality of life of episodic exercise-induced dyskinesia (both P = 0.000). Multiple regression analysis showed that the self-healing tendency (P = 0.024) and depressive symptoms (P = 0.000) were significantly associated with the quality of life-induced exercise-induced dyskinesia. The effects of self-healing tendency were R Depressive symptoms (R ~ 2 = 0.398). Conclusions Patients with episodic exercise-induced dyskinesia generally have mental and psychological burdens and have poor quality of life in terms of their physical, mental, and independence and social relationships. Clinicians should make timely psychological assessment of psychosocial symptoms that may occur in patients with episodic motor-induced dyskinesia and necessary psychological intervention, with particular attention to patients with a higher depressive symptoms score and no tendency to heal themselves.