Psychological Status Assessment In Patients With Vitiligo With SCL-90 And Its Relationship With TCM Syndrome

Objective:A self-made questionnaire and SCL-90 scale were adopt for the patients diagnosed as vitiligo,the aim of this survey is to assess the validity and reliabity of SCL-90 scale while using for investigating the psychological condition of patients with vitiligo,statistical general situation and mental health status of vitiligo patients at the same time.Grouping according to the TCM syndromes,to compare different syndrome of vitiligo patientspsychological status whether there is a difference.Method:1.350 patients with vitiligo were investigated by using SCL-90 symptom self-rating scale in the dermatology outpatient department of our hospital.The scores of each scale were recorded into the database to verify the itemdifferentiation,reliability and validity of the SCL-90 scale.2.The epidemiological characteristics of 350 patients with vitiligo were collected by using a unified self-made basic condition questionnaire.The self-made questionnaire included gender,age,educational level,treatment history,course of disease,season of first onset,season of disease progression,severity of skin lesions,location of skin lesions,clinical classification,stage,etc.,and the four diagnoses were combined to carry out TCM syndrome differentiation and classification of patients.3.The 90 items of the SCL-90 scale can be classified into 9 dimensions(including anxiety,depression,somatization,etc.).Patients were grouped according to TCM syndromes,the scores of each group in each dimension were compared,and the differences between groups were statistically analyzed.4.All data were recorded in Epidata 3.1 software,which was used to establish the database,and SPSS 25.0 software was used for statistical processing.The reliability test includes internal consistency reliability,split and half reliability,and structural validity.Descriptive statistics of variables were made by means of mean and percentage.Univariate analysis methods included T test,analysis of variance,chi-square test,etc.Pair comparison among multiple factors was performed by LSD test.The significance test level of the statistical results was P=0.05,and P<0.05 was statistically significant.Results:1.Except for the item discrimination of the 60th question(0.205),the items of the SCL-90 scale are all above 0.3,and the item discrimination of 80 questions is above 0.4.The scale can accurately reflect the psychological traits to be measured on the whole.2.The homogeneity reliability of the total table of SCL-90 is 0.960,and the split-half reliability is 0.929;The homogeneity reliability of each subscale ranged from 0.606 to 0.849,and the split half reliability ranged from 0.637 to 0.862.The reliability of total scale and subscale are good,which means the test has strong reliability.3.The correlation coefficients between each subscale and the total scale ranged from 0.707 to 0.877;The correlation coefficients of each subscale ranged from 0.446 to 0.766.The correlation coefficient between each subscale and total scale is higher and better than that between each subscale.There are eight common factors extracted by exploratory factor analysis,and the contribution rate of cumulative variance is low.The validity of total scale is good,but the validity of subscale is poor.The accuracy of SCL-90 scale is generally high.4.There were 131 male patients and 219 female patients,with a male-to-female ratio of 0.60:1;The mean age of onset of the patients was 34.84±12.78 years,and the difference is statistically significant between male and female(P<0.05);There are 58 cases with smoking history and 98 cases with drinking history.Homomorphic reactions are observed in 61 patients.150 patients(42.86%)have a course of disease less than 1 year;Vitiligo is easy to appear and worsen in spring and summer;The skin lesion area of nearly 70%patients accounted for less than 1%of the body surface area;White spots in the face,neck,hands,trunk parts;33.14%patients were considered to have psychological disorders.5.There are 92 cases of segmental type,219 cases of common type,7 cases of mixed type,and 32 cases of limited type.There are 106 cases in rapid progression stage,164 cases in advanced stage and 80 cases in stable stage.The syndrome differentiation included 137 cases of disharmony between qi and blood,110 cases of liver stagnation and qi stagnation,47 cases of deficiency of liver and kidney,44 cases of weakness of spleen and stomach,and 12 cases of stasis of meridians.6.Patients with liver depression and Qi stagnation syndrome are more prone to psychological disorders than patients with other syndromes,and the difference is statistically significant.Among the 8 dimensions of OBS,INT,DEP,ANX,HOS,PHO,PAR and PSY,the average score of the liver stagnation and qi stagnation group is the highest.LSD test shows that there are statistically significant differences between the liver stagnation and qi stagnation group and the other four groups in some dimensions.Among them,patients with liver stagnation and qi stagnation syndrome are more likely to appear somatization,obsessive symptoms,interpersonal sensitivity,anxiety,hostility,terror,paranoia and other psychological problems than patients with Qi and blood disharmony syndrome.In obsessive symptoms,depression,psychosis and other aspects of mental health are more prone to problems than patients with syndrome of spleen and stomach weakness and meridian stasis;In anxiety,depression,psychosis and other aspects than the deficiency of liver and kidney syndrome patients are more prone to adverse psychological mood.Conclusion:1.The SCL-90 scale has good item differentiation.In the psychological survey of patients with vitiligo,the reliability and validity of the scale are good,while the structural validity of the subscale is poor,but it is basically suitable for the mental health survey of patients with vitiligo2.There are differences in the psychological conditions of patients with vitiligo with different TCM syndromes.In the process of syndrome differentiation and nursing,attention should be paid to the psychological conditions of patients and appropriately supplemented with psychological counseling and other treatments.