嗅觉倒错与生活质量受损相关，且独立于嗅觉功能和抑郁症状。

文献信息

中文摘要

背景： 嗅觉倒错是一种定性嗅觉障碍，常发生于感染后。尽管它常与部分保留的嗅觉功能共存，但仍可显著损害生活质量（QoL）。定性嗅觉障碍与定量嗅觉障碍（OD）之间的相互作用及其情感负担仍不清楚。本研究在心理物理学-心理学框架内检验了嗅觉倒错对嗅觉相关生活质量的特定贡献。
方法： 在这项横断面研究中，348例OD患者接受了Sniffin' Sticks测试（TDI）、嗅觉障碍问卷-积极和消极陈述（QOD-NS和QOD-PS）以及用于评估抑郁症状的PHQ-2评估。采用校正线性回归模型检验主效应和交互效应，随后进行抑郁校正分析。
结果： 与无嗅觉倒错的患者相比，有嗅觉倒错的患者更年轻且TDI评分更高。嗅觉倒错与较差的嗅觉相关生活质量（较高的QOD-NS）和降低的应对能力（较低的QOD-PS）相关。在加性模型中，嗅觉倒错预测较高的QOD-NS和较低的QOD-PS，而TDI预测较低的QOD-NS，但与QOD-PS无关。抑郁症状与较差的嗅觉相关生活质量密切相关，并显著增加了模型解释的方差。然而，在校正抑郁症状后，嗅觉倒错仍是QOD-NS和QOD-PS的独立预测因子。在不同TDI类别中，嗅觉相关生活质量因嗅觉倒错状态而异，尽管未观察到TDI与嗅觉倒错之间的交互作用。
结论： 嗅觉倒错对嗅觉相关生活质量构成一种独特且具有临床相关性的负担，这种负担不能由定量嗅觉障碍或抑郁症状解释。理解这种独立负担对于有针对性的临床管理至关重要。

英文摘要

BACKGROUND: Parosmia is a qualitative olfactory disorder that frequently occurs after infection. Although it often co-exists with partially preserved olfactory function, it can substantially impair quality of life (QoL). The interplay between qualitative and quantitative olfactory dysfunction (OD), and their affective burden, remains unclear. This study examined the specific contribution of parosmia to olfaction-related QoL within a psychophysical-psychological framework.
METHODS: In this cross-sectional study, 348 patients with OD underwent assessment using the Sniffin' Sticks test (TDI), the Questionnaire of Olfactory Disorders - Positive and Negative Statements (QOD-NS and QOD-PS), and the PHQ-2 for depressive symptoms. Adjusted linear regression models tested main and interaction effects, followed by depression-adjusted analysis.
RESULTS: Patients with parosmia were younger and had higher TDI scores than patients without parosmia. Parosmia was associated with poorer olfaction-related QoL (higher QOD-NS) and reduced coping ability (lower QOD-PS). In additive models, parosmia predicted higher QOD-NS and lower QOD-PS, while TDI predicted lower QOD-NS but was not related to QOD-PS. Depressive symptoms were strongly associated with poorer olfaction-related QoL and substantially increased the explained variance of the models. However, after adjustment for depressive symptoms, parosmia remained an independent predictor of both QOD-NS and QOD-PS. Across TDI categories, olfaction related QoL differed by parosmia status, although no interaction between TDI and parosmia was observed.
CONCLUSION: Parosmia represents a distinct and clinically relevant burden on olfaction related QoL that is not explained by quantitative olfactory dysfunction or depressive symptoms. Understanding this independent burden is critical for targeted clinical management.