突发性耳聋患者焦虑、抑郁与睡眠质量、应对方式的相关性-现代医学

突发性耳聋患者焦虑、抑郁与睡眠质量、应对方式的相关性

单位：苏州大学附属第二医院五官科, 江苏苏州 215004

分类号：R764

出版年·卷·期（页码）：2025·53·第十二期（1901-1907）

摘要：

目的：分析突发性耳聋(SD)患者焦虑、抑郁状况与睡眠质量、应对方式的相关性，并分析其影响因素。方法：采用便利抽样法，选取2022年1月至2023年12月期间本院收治的146例SD患者为研究对象，通过焦虑自评量表(SAS)、抑郁自评量表(SDS)、匹兹堡睡眠质量指数(PSQI)及医学应对问卷(MCMQ)进行评估；采用Spearman或Pearson相关分析评估心理状态(SAS/SDS)与睡眠质量(PSQI)、应对方式(MCMQ)的相关性；采用多因素Logistic回归分析探讨焦虑、抑郁发生的影响因素。结果： SD患者SAS标准总分为(52.04±11.74)分；SDS标准总分为(58.75±10.76)分。 PSQI总分中位数为14.00分，MCMQ中面对条目均分为(2.30±0.28)分。相关分析显示，焦虑和抑郁评分均与PSQI总分、MCMQ中的回避及屈服维度评分呈正相关(r=0.200~0.349，均P<0.05)，而与面对维度评分呈负相关(r=-0.229、-0.224，均P<0.05)。Logistic回归分析显示，重度/极重度听力损失(OR=2.280，95%CI 1.218~4.268)、伴发耳鸣(OR=2.735，95%CI 1.099~6.803)、眩晕(OR=2.259，95%CI 1.040~4.909)、PSQI总分(OR=1.387，95%CI 1.066~1.803)及MCMQ-回避评分(OR=1.581，95%CI 1.007~2.481)是SD患者焦虑发生的危险因素(P＜0.05);女性(OR=2.573，95%CI 1.170~5.657)、重度/极重度听力损失(OR=3.146，95%CI 1.569~6.308)、伴发眩晕(OR=2.230，95%CI 1.139~4.368)、PSQI总分(OR=1.380，95%CI 1.059~1.798)及MCMQ-屈服评分(OR=1.682，95%CI 1.055~2.682)是SD患者抑郁发生的危险因素(P＜0.05);而MCMQ-面对评分是焦虑(OR=0.657，95%CI 0.444~0.972)、抑郁(OR=0.681，95%CI 0.502~0.925)发生的保护因子(P＜0.05)。结论： SD患者易出现焦虑、抑郁情绪，与其睡眠质量及应对方式密切相关，且受性别、听力损失程度、伴发症状影响。

Objective: To investigate and analyze the correlation of anxiety and depression with sleep quality and coping style in patients with sudden deafness(SD), and to explore their influencing factors. Methods: A total of 146 SD patients admitted to our hospital from January 2022 to December 2023 were selected by convenience sampling method. Assessments were conducted using the Self-Rating Anxiety Scale(SAS), Self-Rating Depression Scale(SDS), Pittsburgh Sleep Quality Index(PSQI), and Medical Coping Modes Questionnaire(MCMQ). Spearman or Pearson correlation analysis was used to evaluate the relationships between psychological status(SAS/SDS scores) and sleep quality(PSQI) or coping styles(MCMQ). Multivariate Logistic regression analysis was employed to identify factors influencing the occurrence of anxiety and depression. Results： The total standard score of SAS in SD patients were(52.04±11.74) points, and those of SDS were(58.75±10.76) points. The median total PSQI score was 14.00, and the average score of “facing” item in MCMQ was(2.30±0.28) points. Correlation analysis showed that both anxiety and depression scores were positively correlated with the total PSQI score, as well as with the “Avoidance” and “Resignation” dimensions of MCMQ(r =0.200–0.349, all P<0.05), while negatively correlated with the “Confrontation” dimension(r=-0.229, -0.224, both P<0.05); Logistic regression analysis showed that severe/extremely severe hearing loss(OR=2.280，95%CI 1.218-4.268), accompanied tinnitus(OR=2.735, 95%CI 1.099-6.803), vertigo(OR=2.259, 95%CI 1.040-4.909), total PSQI score(OR=1.387, 95%CI 1.066-1.803), and MCMQ-avoidance score(OR=1.581, 95%CI 1.007-2.481) were risk factors for anxiety in SD patients(P<0.05). Female(OR=2.573, 95%CI 1.170-5.657), severe/extremely severe hearing loss(OR=3.146, 95%CI 1.569-6.308), accompanied by vertigo(OR=2.230, 95%CI 1.139-4.368), total PSQI score(OR=1.380, 95%CI 1.059-1.798) and MCMQ-yield score(OR=1.682, 95%CI 1.055-2.682) were risk factors for depression in SD patients(P<0.05). The MCMQ-face score was a protective factor for the occurrence of anxiety(OR=0.657, 95%CI 0.444-0.972) and depression(OR=0.681, 95%CI 0.502-0.925)(P<0.05). Conclusion： SD patients are prone to anxiety, depression and other adverse emotions, which are closely related to their sleep quality and coping styles, which is affected by gender, hearing loss degree and concomitant symptoms.

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