摘要：

研究背景 发作性运动诱发性运动障碍是一组由突然动作诱发的非随意性运动障碍性疾病，表现为反复发作的短暂性肌张力障碍或舞蹈样动作。本研究旨在调查中国发作性运动诱发性运动障碍患者社会心理学特点，并探讨发作性运动诱发性运动障碍及其相关影响因素之间的关系。 方法 采用自行设计的发作性运动诱发性运动障碍调查问卷对188 例发作性运动诱发性运动障碍患者进行调查，包括症状自测量表（SCL-90）和世界卫生组织生活质量量表（WHOQoL-100）两部分，分别评价精神心理症状和生活质量，Pearson 相关分析和偏相关分析以及多重回归分析评价发作性运动诱发性运动障碍生活质量及其相关影响因素之间的关系。 结果 188 例患者最终回收有效问卷120 份，与中国人群常模数据相比，发作性运动诱发性运动障碍患者SCL-90 量表中文版之躯体化（P = 0.000）、强迫症状（P = 0.000）、人际关系敏感（P=0.000）、抑郁症状（P = 0.000）、焦虑症状（P = 0.000）、敌对（P = 0.000）、恐怖（P =0.000）、偏执（P = 0.000）和精神病性症状（P = 0.000）以及总症状指数均增加，WHOQoL-100 量表中文版之总体生活质量（P = 0.000）和生理（P = 0.000）、心理（P = 0.000）、独立性（P = 0.000）、社会关系（P =0.000）评分均降低。Pearson 相关分析和偏相关分析显示，发作类型之复杂型发作性运动诱发性运动障碍和自愈倾向与发作性运动诱发性运动障碍生活质量呈正相关（P = 0.016，0.000），躯体化、强迫症状、人际关系敏感、抑郁症状、焦虑症状、敌对、恐怖、偏执、精神病性症状等精神心理症状与发作性运动诱发性运动障碍生活质量呈负相关（均P = 0.000）。多重回归分析显示，自愈倾向（P = 0.024）和抑郁症状（P =0.000）与发作性运动诱发性运动障碍生活质量显著相关，其影响程度依次为自愈倾向（R₂ = 0.423）和抑郁症状（R₂ = 0.398）。 结论 发作性运动诱发性运动障碍患者普遍存在精神心理负担，且在生理、心理、独立性和社会关系方面生活质量较差。临床医师应对发作性运动诱发性运动障碍患者可能存在的精神心理症状进行及时评价和必要心理干预，尤其应注意抑郁症状评分较高且无自愈倾向的患者。

关键词: 运动障碍, 神经心理学, 生活质量

Abstract:

Background  Paroxysmal kinesigenic dyskinesia (PKD) is a rare involuntary movement disorder characterized by transient and recurrent dystonic or choreoathetoid attacks triggered by sudden voluntary movements. Since 2011, progress in genetics and pathophysiology has been made. Our study aimed to investigate and analyze the characteristics of social behavior, quality of life and related factors in patients with PKD in China.  Methods  A cross.sectional study was conducted regarding health.related behaviors in 188 patients with PKD by using the Chinese Version of Symptom Check List-90 (SCL-90) and World Health Organization Quality of Life-100 (WHOQoL -100) questionnaires. Psychometric symptoms, mental health, quality of life and related factors were all investigated and analyzed.  Results  A total of 120 valid questionnaires were statistically analyzed. Compared with Chinese norm, patients with PKD showed significantly higher scores in global severity index (GSI, P = 0.000) and SCL-90 scores (somatization, obsessive . compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism; P = 0.000, for all). Patients with PKD also showed significantly lower scores than Chinese norm in general quality of life (P = 0.000) and four domains of WHOQoL -100 (physiological domain, psychological domain, independence domain, social relationship domain; P = 0.000, for all). Pearson and partial correlation analysis showed that quality of life of PKD patients was in positive correaltion with complex PKD and remission (P = 0.016, 0.000), while was in negative correaltion with somatization, obsessive.compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism (P = 0.000, for all). The results of multiple linear regresssion analysis showed that lower quality of life was in association with remission (P = 0.024) and depression (P = 0.000). The degree of impact was R₂ value 0.423 for remission and R₂ value 0.398 for depression.  Conclusions The prevalence of psychometric symptoms and poor quality of life in PKD patients were studied and the efforts to recognize and detect comorbid interictal psychological distress were important, especially for the patients with higher depression score and without remission trend.

Key words: Movement disorders, Neuropsychology, Quality of life