心理疾病和慢性咳:哪一个占主导地位? 临床特征的比较
Tongyangzi Zhang1, Heng Wu2, Wanzhen Li1
1Department of Pulmonary and Critical Care Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China.
Therapeutic advances in chronic disease
|June 16, 2023
概括
与二次焦虑和抑郁症 (SCC) 患者相比,患有先前存在的心理并发症 (PCC) 的慢性咳患者表现出明显的临床特征. PCC患者从心理治疗中受益,而SCC患者需要为咳进行病因治疗.
科学领域:
- 精神病体医学是一种精神病体医学.
- 呼吸系统医学 呼吸系统医学
- 临床心理学 临床心理学
背景情况:
- 慢性咳是一种常见的疾病,对生活质量产生重大影响.
- 经常在慢性咳患者中观察到包括焦虑和抑郁症在内的心理并发症.
- 区分先前存在的心理并发症 (PCC) 和二次焦虑/抑郁症 (SCC) 对于有效的管理至关重要.
研究的目的:
- 为了比较慢性咳患者的临床特征与先前存在的心理并发症 (PCC) 和二次焦虑和抑郁症 (SCC) 的患者.
- 建立诊断和治疗患有慢性咳的个体的心理并发症的基础.
- 评估患者健康问卷 (PHQ) -9和一般焦虑障碍 (GAD) -7尺度在识别PCC的诊断实用性.
主要方法:
- 一项前性研究涉及203名慢性咳患者,分为PCC,SCC和慢性咳没有焦虑/抑郁症 (CC) 组.
- 综合性评估包括一般临床数据,素咳敏感性,咳症状得分,莱斯特咳问卷 (LCQ) 和精神病学尺度.
- 分析PHQ-9和GAD-7得分的PCC诊断价值,以及随访数据.
主要成果:
- 与SCC患者相比,PCC患者的咳持续时间较短,夜间症状较轻,LCQ得分较低,PHQ-9和GAD-7得分较高.
- 综合PHQ-9和GAD-7得分显示PCC的诊断准确度很高 (AUC=0.88,敏感性=90.0%,特异性=73.85%).
- 心理治疗改善了PCC的咳症状,但没有改善心理状态;SCC患者在因果咳治疗后在心理上有所改善.
结论:
- 在慢性咳患者中,PCC和SCC之间存在不同的临床特征.
- 心理尺度对于区分PCC和SCC非常有价值.
- 综合性精神病体诊断有助于及时管理;PCC保证了专注的心理治疗,而SCC受益于病因性咳治疗.
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