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

摘要： 背景　疾病认知与治疗依从性、疗效及预后的关系已得到充分研究，但主要集中在躯体疾病患者。躯体症状障碍（SSD）是临床上处理较为棘手的一种精神疾病，患者普遍对症状和疾病缺乏较好的认识能力，而对SSD患者疾病认知的研究却鲜见报道。目的　探索SSD患者疾病认知现状及其影响因素。方法　选择2018年4—11月于四川省人民医院心身医学中心住院的SSD患者为研究对象，采用一般情况问卷，自制疾病认知问卷，症状自评量表（SCL-90），艾森克人格问卷（EPQ）评估其疾病认知、心理健康状态及人格特征，并进行事件相关电位（ERP）检测。采用Pearson相关分析进行疾病认知现状的相关性研究，采用多元线性回归分析探讨疾病认知现状的影响因素。结果　共发放问卷135份，回收有效问卷130份，问卷有效回收率96.3%。84.6%（110/130）的患者对所患疾病相当不了解；52.7%（69/130）的患者对药物依赖或成瘾存在较大程度的担心；49.1%（64/130）的患者对药物副作用存在较大程度的担心；43.6%（57/130）的患者基本不接受自己是精神心理疾病；61.8%（80/130）的患者存在较重的沮丧和无助感；55.4%（72/130）的患者对于“可根据自身情况自行停药减药”的错误行为有较大的认可度。患者对疾病了解度得分与对精神心理疾病接受度得分（r=0.278，P=0.005）、对自行减药停药认可程度得分（r=0.328，P=0.001）呈正相关；患者对药物依赖或成瘾的担心得分与对药物副作用的担心得分呈正相关（r=0.561，P<0.001）；患者对精神心理疾病接受度得分与对自行减药停药认可程度得分呈正相关（r=0.263，P=0.007），与沮丧和无助感得分呈负相关（r=-0.244，P=0.013）。多元线性回归分析结果显示，患者长期居住在城市、对自行减药停药的认可程度、焦虑及躯体化程度是对疾病了解度的影响因素（P<0.05）。对疾病了解度、对药物副作用的担心程度、N2潜伏期是患者对药物依赖或成瘾的担心程度的影响因素（P<0.05）。对药物依赖或成瘾的担心程度、N2潜伏期是对药物副作用担心程度的影响因素（P<0.05）。患者对疾病了解度、恐怖程度、MMN潜伏期是对精神心理疾病接受程度的影响因素（P<0.05）。性别、对精神心理疾病接受度、内-外性（E）程度、P50抑制率是患病后沮丧无助感的影响因素（P<0.05）。患者对疾病了解度、MMN潜伏期是对自行停药减药认可程度的影响因素（P<0.05）。结论　SSD患者疾病认知程度较差，其人格特征、性别、长期居住地、个体躯体化、焦虑程度，以及部分脑诱发电位成分可部分影响或预测患者的疾病认知水平，对于预测患者疾病认知并进行有针对性的干预具有一定指导意义。

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