关键词: 精神卫生, 躯体症状障碍, 疾病认知, 影响因素, 人格, 事件相关电位

Abstract: Background　The relationship of illness perception with treatment compliance，therapeutic effectiveness and prognosis has been fully studied，but mainly in patients with physical diseases.Somatic symptom disorder（SSD）is a kind of mental disorder which is difficult to deal with clinically.SSD patients generally lack a good understanding of the symptoms and the disease.However，the research on illness perception of such patients is rarely reported.Objective　The aim of this study was to explore the illness perception and influencing factors in patients with SSD.Methods　SSD patients who were hospitalized in Department of Psychosomatic Medicine，Sichuan Provincial People's Hospital from April to November 2018 were enrolled.The General Demographics Questionnaire and Simplified Somatic Symptom Disorder Perception Questionnaire developed by our research group were used to collect the demographics，and to assess illness perception，respectively.The Symptom Checklist 90，and Eysenck Personality Questionnaire were used to evaluate mental health status and personality characteristics，respectively.Event-related potentials were also measured.Partial correlation analysis was used to analyze the correlation among the perception dimensions of illness.Pearson correlation analysis was used to analyze the influential factors of SSD perception.Results　130 of the 135 participants（96.3%）who returned responsive questionnaires were included in the final analysis.Among them，84.6%（110/130）knew little about SSD；52.7%（69/130）worried about developing drug dependence or drug addiction very much；49.1%（64/130）were very fearful of drug side effects；43.6%（57/130）did not accept the diagnosis of SSD as a mental disorder generally；61.8%（80/130）had relatively severe depression and helplessness；55.4%（72/130）showed relatively high level of approval for “One can independently discontinue or reduce the medication based on self-perceived health conditions”（a wrong medication behavior actually）.SSD perception score was positively correlated with the score for accepting the diagnosis of SSD as a mental disorder（r=0.278，P=0.005），and the score for approving “One can independently discontinue or reduce the medication based on self-perceived health conditions”（r=0.328，P=0.001）.The score for concern about drug dependence or drug addiction was positively correlated with the score for concern about drug side effects（r=0.561，P<0.001）.The score for accepting the diagnosis of SSD as a mental disorder was positively correlated with the score for approving “One can independently discontinue or reduce the medication based on self-perceived health conditions”（r=0.263，P=0.007），but was negatively correlated with SSD-induced depression and helplessness score（r=-0.244，P=0.013）.Multiple linear regression analysis indicated that long-term urban residence，level of approving “One can independently discontinue or reduce the medication based on self-perceived health conditions”，and levels of anxiety and somatization were associated with SSD perception（P<0.05）.The levels of SSD perception and concern about drug side effects，and the N2 latency period were associated with the level of concern about drug dependence or drug addiction（P<0.05）.The level of concern about drug dependence or drug addiction，and the N2 latency period was associated with the level of concern about drug side effects（P<0.05）.SSD perception，fear of SSD and MMN latency period were associated with the acceptance of the diagnosis of SSD as a mental disorder（P<0.05）.Gender，acceptance of the diagnosis of SSD as a mental disorder，internal-external（E）score，and P50 inhibition rate were the influencing factors for SSD-induced depression and helplessness（P<0.05）.SSD perception and MMN latency period were the influencing factors for the approval of independently discontinue or reduce the medication（P<0.05）.Conclusion　Patients with SSD have poor SSD perception，which is partly affected or predicted by personality characteristics，gender，long-term residence，individual somatization，anxiety level，and some components of brain evoked potentials，having a significance in guiding assessing patients' illness perception and carrying out targeted intervention in early stage of treatment.

Key words: Mental health, Somatic symptoms disorder, Illness perception, Influencing factors, Personality, Event-related potential