Kern S, Schrempf W, Schneider H, Schultheiss T, Reichmann H, Ziemssen T
Department of Neurology, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Germany.
Mult Scler. 2009 Jun;15(6):752-8. doi: 10.1177/1352458509103300.
Psychological distress and psychiatric co-morbidity are common in multiple sclerosis (MS) and is often associated with neurological disability as well as reduced quality of life.
This study aimed to investigate psychological distress and the possible association with quality of life as well as neurological disability in MS patients within the first 3 years after diagnosis.
Psychological distress was measured using a standardized questionnaire (Symptom-Check-List-90-R; SCL-90-R) in 31 relapsing-remitting MS patients and 24 sex- and age-matched healthy controls.
Psychological distress was significantly more pronounced in MS patients when compared to healthy controls. Interpersonal sensitivity and psychoticism were positively associated with neurological disability (Expanded Disability Status Scale [EDSS]). A high EDSS group (median split EDSS; 1.5) expressed significantly more psychological distress when compared to the low EDSS group and healthy controls. MS patients with minimal to no neurological disability (low EDSS group) also expressed significantly more emotional distress when compared to healthy controls. MS-related quality of life was positively associated with neurological disability as well as SCL-90-R scores. After adjusting for neurological disability, psychological distress was still significantly associated with quality of life.
Early stage MS patients significantly differ in their psychological distress when compared to healthy controls. Psychological distress in these patients is associated with neurological disability, but it is also present in patients with minimal to no neurological disability. Psychological distress was identified as an independent predictor for MS-related quality of life.
心理困扰和精神共病在多发性硬化症（MS）中很常见，并且常常与神经功能残疾以及生活质量下降相关。
本研究旨在调查确诊后前3年内MS患者的心理困扰及其与生活质量和神经功能残疾的可能关联。
使用标准化问卷（症状自评量表90修订版；SCL-90-R）对31例复发缓解型MS患者和24例性别及年龄匹配的健康对照者进行心理困扰测量。
与健康对照者相比，MS患者的心理困扰明显更显著。人际敏感和精神病性与神经功能残疾（扩展残疾状态量表[EDSS]）呈正相关。高EDSS组（EDSS中位数分割；1.5）与低EDSS组和健康对照者相比，表现出明显更多的心理困扰。神经功能残疾最小或无神经功能残疾的MS患者（低EDSS组）与健康对照者相比，也表现出明显更多的情绪困扰。MS相关生活质量与神经功能残疾以及SCL-90-R评分呈正相关。在调整神经功能残疾因素后，心理困扰仍与生活质量显著相关。
与健康对照者相比，早期MS患者在心理困扰方面存在显著差异。这些患者的心理困扰与神经功能残疾相关，但在神经功能残疾最小或无神经功能残疾的患者中也存在。心理困扰被确定为MS相关生活质量的独立预测因素。
