甲状腺功能减退症患者心理健康状况及影响因素分析

目的:研究甲状腺功能减退症患者的心理健康状况及其影响因素,为预防、改善甲减患者心理健康状况提供参考依据。方法:选取2014年1月-2016年1月来我院治疗的226例甲减患者作为甲减组,另从杨浦区多个社区随机抽取同期254例健康者作为健康组,采用SCL-90症状自评量表、社会支持评定量表(SSRS)及一般情况调查问卷对两组研究对象进行调查,采用Logistic回归分析甲减患者的影响因素。结果:两组性别、年龄及职业之间的差异无统计学意义(P0.05),而文化程度、经济收入的差异具有统计学意义(P0.05);甲减组患者强迫症状、抑郁、焦虑、精神病性评分及总分均高于健康组(P0.05);甲减组患者中焦虑、抑郁、人际关系敏感所占比重较高,分别为30.97%,26.11%,26.11%;与健康组相比,甲减组患者SSRS评分中主观支持、客观支持、支持利用度评分及总分均明显降低(P0.05);多因素Logistic回归分析显示社会支持、文化程度为小学、经济收入30000元/年是甲减患者心理健康的影响因素(P0.05)。结论:甲减患者心理状况较差,存在较严重的焦虑和抑郁情况,在治疗同时应注意健康教育和心理关怀,尤其是对收入低、文化程度低或社会支持程度低的患者,应给予及时的心理治疗,可提高患者的生活质量。

Analysis of Mental Health and Influencing Factors of Patients with Hypothyroidism

ABSTRACT Objective: To study the mental health status and the influencing factors of patients with hypothyroidism, and to provide references for prevention and improvement of hypothyroidism patients. Methods: A total of 226 patients with hypothyroidism, who were treated in Affiliated Changhai Hospital of Second Military Medical University from January 2014 to January 2016, were chosen as hy- pothyroidism group, and 254 healthy subjects selected from several communities in Yangpu district as healthy group in the same period. The two groups were investigated by the SCL-90 symptoms self -evaluation scale, social support rating scale (SSRS) and general situa- tion questionnaire. The influencing factors of patients with hypothyroidism were analysed by Logistic regression analysis. Results: There were no statistical differences in the gender, age and occupation between the two groups (P>0.05), but there were statistical differences in the cultural degree and economic income (P<0.05). The scores and total scores of the obsessive compulsive symptoms, depression, anxi- ety and psychoticism in the hypothyroidism group were higher than those in the healthy group (P<0.05). The anxiety, depression, and in- terpersonal sensitivity proportion in the hypothyroidism group were higher, which were 30.97%, 26.11%, 26.11% respectively. Compared with the healthy group, the scores and total scores of subjective support, objective support,and support utilization in the hypothyroidism group were significantly decreased (P<0.05). The multi-factor Logistic regression analysis showed that the influencing factors of mental health in the Hypothyroidism patients were economic income<30000 yuan/year, culture degree and the degree of social support. Conclusion: Hypothyroidism patients have bad mental health, who are suffering from serious anxiety and depression. They should be paid more attention to health education and psychological care during medical treatment, especially for the patients with low income, low level of education or low degree of social support. Reinforcing mental health services can improve the patients'' quality of life.