Hyphantis Thomas N, Christou Konstantinos, Kontoudaki Stavroula, Mantas Christos, Papamichael George, Goulia Panagiota, Konitsiotis Spyros, Mavreas Venetsanos
University of Ioannina Medical School, Dept. of Psychiatry, Greece.
Int J Psychiatry Med. 2008;38(3):307-27. doi: 10.2190/PM.38.3.g.
The aim of the present study was to identify disease parameters, defensive styles and ego strength measurements associated with various forms of psychiatric complications in patients with multiple sclerosis (MS).
Seventy-nine patients with MS participated in the study and 158 healthy subjects matched for age and sex served as controls. A wide range of clinical information was collected and the following self-report instruments were used: General Health Questionnaire, Symptom Distress Check List, Defense Style Questionnaire, MMPI Ego Strength Scale and Hostility and Direction of Hostility Questionnaire.
The odds of being assessed with a psychiatric diagnosis upon interview were 6.7 times greater among patients compared to controls and 9.3 times greater among patients with recent-onset MS compared to patients with long-term disease. Psychiatric complications of MS were closely associated with age of the disease onset and the degree of disability due to MS. Additionally, higher rates of introverted hostility, adoption of maladaptive ego defenses and weakened ego strength were also closely associated with several forms of psychological distress, especially depressive symptoms.
MS patients experience elevated symptoms of psychological distress, especially depressive symptoms, which are most closely associated with disease parameters. However, the crucial role of various personality traits such as ego defenses and hostility features in the psychiatric symptom formation also appear to contribute to the development of depressive symptoms. Clinicians involved in the clinical management of patients with MS should identify and modify treatment if these specific personality markers that indicate the exhaustion of the patient's resources to cope with the physical and psychological stress of the illness are present.
本研究旨在确定与多发性硬化症（MS）患者各种形式精神并发症相关的疾病参数、防御方式和自我力量测量指标。
79例MS患者参与了本研究，158名年龄和性别匹配的健康受试者作为对照。收集了广泛的临床信息，并使用了以下自我报告工具：一般健康问卷、症状困扰检查表、防御方式问卷、明尼苏达多相人格调查表自我力量量表以及敌意与敌意指向问卷。
与对照组相比，患者在访谈时被评估为患有精神疾病诊断的几率高6.7倍；与患有长期疾病的患者相比，近期发病的MS患者被评估为患有精神疾病诊断的几率高9.3倍。MS的精神并发症与疾病发病年龄和MS所致残疾程度密切相关。此外，内向敌意、采用适应不良的自我防御以及自我力量减弱的发生率较高也与几种形式的心理困扰密切相关，尤其是抑郁症状。
MS患者经历了心理困扰症状的增加，尤其是抑郁症状，这与疾病参数最为密切相关。然而，诸如自我防御和敌意特征等各种人格特质在精神症状形成中的关键作用似乎也促成了抑郁症状的发展。参与MS患者临床管理的临床医生如果发现存在这些表明患者应对疾病身心压力资源耗尽的特定人格标志物，应识别并调整治疗方案。
