A Retrospective Study Of Patients With Somatic Symptom Disorder Presenting With Dizziness

Objective:A retrospective study was conducted on somatic symptom disorder patients with dizziness in Neurology clinic and ward.Methods:A retrospectively study was conducted from October 2016 to October 2018 in the First Hospital of Hebei Medical University,which collected 54 somatic symptom disorder patients with dizziness.The study summarized and analyzed the general clinical data,inducement,clinical manifestations,assistant examination which included emotions and autonomic nerve,therapeutic effect about Deanxit.Results:1.The age of SSD patients presenting with dizziness were between 17-78,the average age were 50.69±15.85.The amount of elderly aged over 65 years old were 13,accounting for 24.07%.The severity of somatic symptom disorder was significantly different between the age over 65 and less than 65 years old(P<0.05).The total score of HAMA,HAMD and SCL-90 in patients aged over 65 years were lower than those aged less than 65 years(P<0.05).2.There were 18 males and 36 females in the SSD patients presenting with dizziness,and the ratio of male to female was 1:2.Female patients were higher than male patients in HRV index of SDNN,RMSSD,pNN50,LF and HF(P<0.05).3.All of the 54 SSD patients presenting with dizziness,there were 38 cases education level were technical secondary school and below,accounting for 70.37%.The number of patients who had unstable and stable occupation were 29 and 25 respectively,and the ratio was 1.16:1.26 patients had social stress events like anxiety and anger,fatigue and tension,illness or death of family members and friends,accounting for 48.15%.There were 34 patients with previous medical history,including 16 patients with cerebrovascular disease(cerebral infarction,cerebral hemorrhage,insufficient cerebral artery blood supply),encephalitis,and hypertension that could cause dizziness,accounting for 47.06%.The severity of somatic symptom disorder was significantly different between the two groups with and without previous history(P<0.05).4.All of the 54 SSD patients presenting with dizziness,the average score of HAMA and HAMD was 16.15±4.71 and 15.67±5.05 respectively.There were 29 patients’ score of HAHA was located in 14-21 which means there must be anxiety.There were 33 patients’ score of HAHD was located in 8-20 which means may have symptoms of depression.5.In order to find out whether HAMA,HAMD,SCL-90 and HRV index had the ability to identify the therapeutic effect of Deanxit,we draw ROC curve through SPSS.When the time domain analysis index parameters SDNN in HRV is 30.77ms(sensitivity = 0.750,specificity = 0.618),there was a good discrimination value for the effectiveness of Deanxit.There were 22 patients with abnormal skin sympathetic reaction and 32 patients with normal skin sympathetic reaction.In order to find out the relationship between skin sympathetic response and the therapeutic effect of Deanxit,we performed logistic regression analysis through SPSS.Abnormal skin sympathetic response can increase the risk of the ineffectiveness of Deanxit.(P<0.05,OR = 4.066).Conclusions:1.SSD patients presenting with dizziness can be affected at all ages.The elderly aged over 65 years old have a lower incidence rate and a less severe degree of somatic symptom disorder.2.SSD patients presenting with dizziness are more common in women,especially who are in perimenopausal period.The degree of autonomic nervous dysfunction of female patients is more serious than that of male patients.3.SSD patients presenting with dizziness generally have low education level,unstable occupation,social stress events and previous history.Previous history especially which related to dizziness will increase the severity of the disease.4.Although SSD patients presenting with dizziness accompanied with different level of anxiety and/or depression,the score of HAHA and HAMD was located in there must be anxiety and may have symptoms of depression,can not reach the criteria of anxiety and depression disorder.The level of anxiety and/or depression is positively correlated with the severity of somatic symptom disorder.5.When the time domain analysis index parameters SDNN in HRV is 30.77ms(sensitivity=0.750,specificity=0.618),there was a good discrimination value for the effectiveness of Deanxit.Abnormal skin sympathetic response can increase the risk of the ineffectiveness of Deanxit.(P<0.05,OR = 4.066).