上学恐怖症临床特征及诊断初探

目的:探讨上学恐怖症的临床特征及诊断。方法:采用自编一般人口学问卷、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、症状自评量表(SCL-90)对心理门诊58名上学恐怖症患者进行施测。结果:1上学恐怖症患者躯体症状主要有睡眠障碍、头痛、头晕、胸闷、心悸等;2上学恐怖症患者诊断依次为童年情绪障碍23人(39.66%);心境障碍19人(32.76%);神经症9人(15.52%);精神分裂症4人(6.90%);应激相关障碍3人(5.17%);3上学恐怖症患者HAMA总分及各因子得分显著大于对照组(P0.01);除体重、日夜变化因子外,上学恐怖症患者的HAMD总分、焦虑/躯体化、认识障碍、迟缓、睡眠障碍、绝望感因子得分显著高于对照组(P0.01);4上学恐怖症患者研究组在SCL-90总分、躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性因子上的得分高于正常对照组,差异有统计学意义(P0.01)。结论:上学恐怖症患者普遍存在情绪障碍及躯体症状,了解其相关特点,为上学恐怖症的干预和治疗提供理论指导。

Clinical Characteristics and Diagnosis of School Phobia

Objective:To investigate the common clinical manifestations and diagnosis of school phobia.Methods:58 students with school phobia were tested with the demographic questionnaire,the Hamilton Anxiety Scale,the Hamil-ton Depression Scale and the Symptom Checklist 90.Results:The most common of somatic symptom of students with school phobia were sleep disorders,headache,dizziness,chest tightness and palpitation.The diagnosis of school phobia were childhood emotional disorder 23 persons(39.66%),mood disorders 19 persons(32.76%),neurosis 9 persons(15.52%),schizophrenia 4 persons(6.90%),stress-related disorders 3 persons(5.17%).The total score and other factors scores of HAMA of students with school phobia were significantly higher than the control group(P<0.01).Except for weight,circadian changes,The total score and other factors scores of HAMD of school phobia were significantly higher than those in the control group(P<0.01).The total score,somatization,obsessive-compulsive symptom,interpersonal sensitivity,depression,anxiety,hostile,horror,paranoid,psychotic of SCL-90 were signifi-cantly higher than those in the control group(P<0.01).Conclusion:The mood disorders and somatoform symptoms are commonly existed in students with school phobia.Awareness of the characteristics of school phobia can provide theoretical direction of inventing depression.