Goldstein L H, Atkins L, Landau S, Brown R G, Leigh P N
MRC Center for Neurodegeneration Research, King's College London, Department of Psychology, Institute of Psychiatry, UK.
Neurology. 2006 Nov 14;67(9):1652-8. doi: 10.1212/01.wnl.0000242886.91786.47.
To identify predictors of psychological distress (measured by anxiety and depression) and low self-esteem and to determine whether these change over time in people with ALS.
We interviewed 50 patients with ALS living with a spouse/partner; further interviews were held at median intervals of 6 and then 5 months. Although carers were interviewed, we report the patients' data. Patients completed measures about their social support and marital relationship; the functional impact of ALS; everyday cognitive, emotional, and behavioral changes; symptoms of anxiety and depression; and self-esteem. The ALS Severity Scale was also completed.
From the initial sample of 50, 26 patients were interviewed on all three occasions. At the first interview, negative social support and bulbar impairment were most predictive of psychological distress; pre-illness marital intimacy was the best predictor of patients' self-esteem. Over time, negative social support and pre-illness marital intimacy retained an ability to predict patients' affective state and self-esteem.
Social factors are important in determining longer-term psychological well-being in people with ALS who are in the relatively early stages of the disease.
确定心理困扰（通过焦虑和抑郁衡量）和低自尊的预测因素，并确定这些因素在肌萎缩侧索硬化症（ALS）患者中是否随时间变化。
我们采访了50名与配偶/伴侣共同生活的ALS患者；随后分别在6个月和5个月的中位间隔时间进行了进一步访谈。尽管对照顾者进行了访谈，但我们报告的是患者的数据。患者完成了关于其社会支持和婚姻关系；ALS的功能影响；日常认知、情绪和行为变化；焦虑和抑郁症状；以及自尊的测量。还完成了ALS严重程度量表。
在最初的50名样本中，26名患者在所有三次访谈中均接受了访谈。在第一次访谈时，负面社会支持和延髓功能障碍最能预测心理困扰；病前婚姻亲密度是患者自尊的最佳预测因素。随着时间的推移，负面社会支持和病前婚姻亲密度仍能够预测患者的情感状态和自尊。
社会因素对于确定处于疾病相对早期阶段的ALS患者的长期心理健康很重要。
