Somatic symptoms in patients with acute stroke: clinical features and influencing factors / 国际脑血管病杂志

ABSTRACT

Objective To investigate the clinical features and influencing factors of somatic symptoms in patients with acute stroke.Methods Patients with acute stroke were enrolled in the study.Using the scores of symptom checklist 90 (SCL-90)-somatization factor part,the patients were divided into either a somatic symptom group (≥24) or a control group (＜24).Their age,gender,economic level,education level,underlying diseases,Hamilton Anxiety Scale (HAMA),Hamilton Depression Scale (HAMD),NEO Five-Factor Inventory scores,Social Support Rating Scale scores-simplified Chinese version,Mini-Mental StateExamination (MMSE) scores,National Institute of Health Stroke Scale (NIHSS) scores were documented and analyzed.Results A total of 70 patients with acute stroke were enrolled,and 33 (47.1％) of them had somatic symptoms.There were no significant differences in demographic characteristics,education level,family income,occupation,marital status,living alone,residence,medical expenses payment methods and social support scores between the somatic symptom group and the control group.There were also no significant differences in the types of stroke,lesion side,baseline NIHSS score,MMSE score,and NEO Five-Factor Inventory score between the 2 groups.There was significant difference in lesion side between the somatic symptom group and the control group (x2 =0.161,P=0.006).The comparison of neuropsychological test results showed that the proportion of patients with an anxiety state of the somatic symptom group was significantly higher than that of the control group (24.2％ vs.5.4％;x2 =5.055,P =0.025),but there was no significant difference in the proportion of patients with depression status;after excluding the cases who met the anxiety and depression criteria,HAMA (8.08 ± 3.12 vs.5.58 ± 3.06;t =-3.059,P =0.003) and HAMD (10.80 ± 4.81 vs.7.73 ± 3.88;t =-2.694,P =0.009) scores of the somatic symptom group (n =25) were significantly higher than those of the control group (n =33).The number of somatic symptoms of the somatic symptom group was significantly more than that of the control group (Z =-5.817,P ＜ 0.001),and was more likely to have pain symptoms (97.0％ vs.73.0％;x2 =7.584,P =0.006).The correlation analysis showed that there was a significant positive correlation in the 12-item scores of the SCL-90 somatic factors and HAMA (r =0.494,P ＜0.001) and HAMD (r=0.369,P=0.002) scores in patients.Multivariate logistic regression analysis showed that HAMA score was an independent risk factor for somatic symptoms after stroke.(odds ratio 1.286,95％ confidence interval 1.060-1.560;P=0.011).Conclusions The incidence of somatic symptoms is high after acute stroke,especially in patients with cortical stroke.The somatic patients after stroke are prone to have pain-related symptoms.The patients with anxiety and depression status after stroke are prone to have somatic symptoms after stroke;HAMA score is an independent risk factor for having somatic symptoms after stroke.