Haase Claus G, Lienemann Marc, Faustmann Pedro M
Dept. of Neurology and Clinical Neurophysiology, Knappschafts-Hospital Recklinghausen, Ruhr-University Bochum, Dorstener Str. 151, 45657, Recklinghausen, Germany.
Eur Arch Psychiatry Clin Neurosci. 2008 Feb;258(1):35-9. doi: 10.1007/s00406-007-0759-6. Epub 2007 Nov 7.
Detailed neuropsychological assessment was performed in 86 women (48 patients with stable relapsing-remitting multiple sclerosis (MS) and 38 matched healthy controls (HC)). Patients were categorized into patients without (EDSS < or =1, n = 26) and with physical disability (EDSS > or =2, n = 22). Patients with EDSS > or =2 scored significantly (P < 0.05) higher in Beck's depression inventory (BDI) and depression scores (DS) compared to HC and patients with EDSS < or =1. No significant differences were found with respect to the use of specific coping strategies between the patient groups, who preferred active (EDSS < or =1) or distracting (EDSS > or =2) strategies. Cognitive deficits were significantly increased in MS with EDSS > or =2 with regard to visuo-construction and visual memory, in particular with respect to geometric figures, compared to MS with EDSS < or =1. Significant positive correlations of depression variables (BDI, DS and BL) and depressive as well as denying coping strategies were found. Our results showed increased depression scores and increased cognitive deficits in advanced physically disabled patients, without selection of specific coping strategies. This supports an individual MS-specific neuropsychological therapeutic approach in order to improve disease related deficits together with social functioning.
对86名女性进行了详细的神经心理学评估(48例复发缓解型多发性硬化症(MS)稳定患者和38名匹配的健康对照(HC))。患者被分为无身体残疾组(扩展残疾状态量表(EDSS)≤1,n = 26)和有身体残疾组(EDSS≥2,n = 22)。与健康对照和EDSS≤1的患者相比,EDSS≥2的患者在贝克抑郁量表(BDI)和抑郁评分(DS)上得分显著更高(P < 0.05)。在患者组之间,在使用特定应对策略方面未发现显著差异,他们分别更喜欢积极应对策略(EDSS≤1)或分散注意力策略(EDSS≥2)。与EDSS≤1的MS患者相比,EDSS≥2的MS患者在视觉构建和视觉记忆方面,特别是在几何图形方面,认知缺陷显著增加。发现抑郁变量(BDI、DS和BL)与抑郁以及否认应对策略之间存在显著正相关。我们的结果显示,在晚期身体残疾患者中,抑郁评分增加且认知缺陷增加,且未选择特定的应对策略。这支持了一种针对MS患者的个体化神经心理学治疗方法,以便改善与疾病相关的缺陷以及社会功能。