Ishikura R, Morimoto N, Tanaka K, Kinukawa N, Yoshizawa S, Horiuchi T, Nakashima H, Otsuka T
Department of Neuropsychiatry, Graduate School of Medical Science, Kyushu University, Fukuoka City, Fukuoka-ken, Japan.
Clin Rheumatol. 2001;20(6):394-400. doi: 10.1007/s100670170002.
The subjects consisted of 84 female SLE outpatients who were all over 20 years of age. These patients were able to maintain relatively stable physical conditions and lead normal daily lives, and they were regularly treated at the outpatient clinic. All subjects were Japanese. Psychological features (trait anxiety, state anxiety, depression and suicide ideation) were evaluated using psychological tests, and the relationships between the respective psychological features and background factors were statistically evaluated using stepwise multiple logistic regression analyses. In this study, we found that 'the self-evaluation of not having understood SLE at the time of starting SLE treatment' was the background factor significantly affecting depression or trait anxiety. 'No spouse' had a statistically significant effect on depression, and 'self-awareness as problems of side-effects due to steroids' had a statistically significant effect on state anxiety. We also found 'human relations among family members' and 'high daily steroid dosage' to be significantly correlated with suicide ideation. However, there were no correlations between the psychological features and 'disease activity at the time of investigation' or 'history of neuropsychiatric diseases'. In female SLE outpatients, performing psychological approaches focusing on 'understanding SLE at the beginning of treatment', 'the human relationships among family members', or 'issues related to steroid therapy' may be useful for the early treatment or prevention of various major mental problems.
研究对象为84名年龄均超过20岁的女性系统性红斑狼疮(SLE)门诊患者。这些患者能够维持相对稳定的身体状况并过着正常的日常生活,且定期在门诊接受治疗。所有研究对象均为日本人。使用心理测试评估心理特征(特质焦虑、状态焦虑、抑郁和自杀意念),并通过逐步多元逻辑回归分析对各心理特征与背景因素之间的关系进行统计学评估。在本研究中,我们发现“开始SLE治疗时对SLE不了解的自我评价”是显著影响抑郁或特质焦虑的背景因素。“无配偶”对抑郁有统计学显著影响,“将类固醇副作用视为问题的自我认知”对状态焦虑有统计学显著影响。我们还发现“家庭成员间的人际关系”和“每日类固醇高剂量”与自杀意念显著相关。然而,心理特征与“调查时的疾病活动度”或“神经精神疾病史”之间无相关性。在女性SLE门诊患者中,针对“治疗开始时对SLE的了解”、“家庭成员间的人际关系”或“与类固醇治疗相关的问题”开展心理干预,可能对各种重大心理问题的早期治疗或预防有用。