Department of Psychology, University of Missouri-Kansas City, 4825 Troost Building, Suite 111G, Kansas City, MO 64110, USA.
J Behav Med. 2010 Jun;33(3):219-27. doi: 10.1007/s10865-010-9247-y. Epub 2010 Feb 3.
The purpose of the present study was to prospectively examine the association between treatment adherence and common neuropsychiatric symptoms in multiple sclerosis (MS). Patients underwent a thorough psychiatric and neuropsychological evaluation at the outset of the study. Patient adherence to disease modifying therapies was then tracked for 8 weeks using self-report, a medication diary, and an electronic monitoring device that recorded needle disposals. Results indicated that MS patients with current mood or anxiety disorders were almost five times as likely as MS patients with no psychiatric diagnosis to exhibit problems adhering to their disease modifying therapies. Poor adherence was also associated with memory difficulties, anxiety, depression, neuroticism, and low conscientiousness. Findings highlight the importance of conducting a thorough psychiatric and neuropsychological evaluation when clinicians suspect poor adherence to disease modifying therapies. Pharmacological or psychotherapeutic treatment of mood/anxiety disorders, use of scheduled reminders, and/or increased organization and structure may lead to improved treatment adherence in MS.
本研究的目的是前瞻性地检查多发性硬化症（MS）患者治疗依从性与常见神经精神症状之间的关系。在研究开始时，患者接受了全面的精神病学和神经心理学评估。然后，使用自我报告、用药日记和记录针头处置的电子监测设备，在 8 周内跟踪患者对疾病修正治疗的依从性。结果表明，目前患有情绪或焦虑障碍的 MS 患者出现药物治疗依从性问题的可能性几乎是没有精神科诊断的 MS 患者的五倍。较差的依从性也与记忆困难、焦虑、抑郁、神经质和低尽责性有关。研究结果强调了临床医生怀疑药物治疗依从性差时进行全面的精神病学和神经心理学评估的重要性。对情绪/焦虑障碍进行药物或心理治疗、使用定期提醒以及/或增加组织和结构，可能会提高 MS 的治疗依从性。
