Department of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Germany.
Mov Disord. 2010 Feb 15;25(3):309-14. doi: 10.1002/mds.22900.
To investigate the health-related quality of life (HrQoL) of adult patients with Gilles de la Tourette's syndrome (GTS) in Germany. HrQoL was evaluated in 200 adult patients with GTS (Mean age: 34.9 +/- 11.8 years). Patients were recruited from three outpatient departments in Germany and completed a semi-structured, self-rating interview. HrQoL was measured using the EQ-5D. Depression was assessed using the Beck's depression inventory (BDI) and clinical symptoms using the Yale Tourette syndrome symptom list (TSSL) and the Shapiro Tourette-syndrome severity scale (STSSS). Multivariate regression analyses were performed to identify independent predictors of HrQoL. Patients with GTS proved to have a worse HrQoL than a sample from the general German population. The domains most affected were anxiety/depression (57.1%), followed by pain/discomfort (47.5%), usual activities (38.4%), mobility (14%), and self-care (6.6%). The mean EQ-5D visual analog scale (EQ-VAS) was 65.4 +/- 21.9. The patients had a mean BDI score of 12.3 +/- 9.9, which was considerably worse compared to a healthy group who had a score of 6.45 +/- 5.2. The mean STSSS value was 3.2 +/- 1.1. In multivariate analyses, depressive symptoms contributed considerably, whereas the severity of symptoms as well as age only contributed minimally to HrQoL in the model (R(2) = 0.54). HrQoL is considerably reduced in adult patients with GTS. The main independent factors for determining HrQoL were depression, severity of symptoms, and age. Although, treatment of tics is important, co-morbidities such as depression should be diagnosed and treated vigorously.
调查德国成年 Gilles de la Tourette 综合征（GTS）患者的健康相关生活质量（HrQoL）。 方法：共纳入德国三家门诊部门的 200 例成年 GTS 患者（平均年龄：34.9±11.8 岁），采用半结构式自我报告问卷调查的方式评估患者的生活质量。采用 EQ-5D 量表评估生活质量，贝克抑郁自评量表（BDI）评估抑郁，耶鲁抽动障碍严重程度量表（TSSL）和 Shapiro 抽动障碍严重程度量表（STSSS）评估临床症状。采用多元回归分析识别影响生活质量的独立预测因素。 结果：与德国普通人群相比，GTS 患者的生活质量更差。受影响最严重的领域依次为焦虑/抑郁（57.1%）、疼痛/不适（47.5%）、日常活动（38.4%）、行动能力（14%）和自理能力（6.6%）。EQ-5D 视觉模拟量表（EQ-VAS）评分的平均值为 65.4±21.9。患者的 BDI 评分为 12.3±9.9，明显高于健康对照组（6.45±5.2）。STSSS 平均值为 3.2±1.1。多元回归分析显示，抑郁症状对生活质量的影响较大，而症状严重程度和年龄对模型中生活质量的影响较小（R2=0.54）。 结论：成年 GTS 患者的生活质量明显下降。决定生活质量的主要独立因素是抑郁、症状严重程度和年龄。尽管 tic 的治疗很重要，但应积极诊断和治疗共病，如抑郁。
