Division of Medicine, Akershus University Hospital, Lorenskog, Norway; Department of Behavioural Science, University of Oslo, Oslo, Norway.
J Psychosom Res. 2010 Jun;68(6):567-72. doi: 10.1016/j.jpsychores.2009.11.004. Epub 2009 Dec 16.
The purpose of this study is to investigate the long-term effects of participation in a cardiovascular screening program and of dietary counseling on self-reported psychosocial outcomes and health concerns.
High-risk subjects (n=563) with hyperlipidemia from the Oslo Diet and Antismoking Study (1972-1977) were reexamined after 25 years and randomly assigned to a new 3-year prospective 2x2 factorial placebo-controlled study in 1997 of n-3 polyunsaturated fatty acids and/or dietary counseling. Hospital Anxiety and Depression Scale (HADS), Life Satisfaction Index (LSI), and a new questionnaire on health concerns and behavior in response to risk information were collected at the 25-year follow-up. Hospital Anxiety and Depression Scale and LSI were evaluated at the end of the 3-year Diet and Omega-3 Intervention Trial on atherosclerosis (DOIT) in 505 subjects.
Twenty-five years after the screening program, HADS-anxiety was similar to the Norwegian norms (3.3 vs. 3.5), while HADS-depression was significantly lower (3.6 vs. 4.1, P<.01). Patients reported that 25 years of awareness of hyperlipidemia had influenced health concerns through a moderate change in diet habits, some restriction in life conduct, but an improvement of the total life situation. After a novel 3-year intervention in DOIT, there was no difference between the dietary counseling and control group with regard to anxiety, depression, or life satisfaction, but HADS-anxiety increased significantly (4.0 vs. 3.3, P<.001) in both groups.
Compared to the general population, screening-positive subjects did not have increased mental distress 25 years after screening, and beneficial health behavior persisted. Dietary counseling did not affect psychosocial outcomes.
本研究旨在探讨参与心血管筛查计划和饮食咨询对自我报告的心理社会结果和健康关注的长期影响。
1972-1977 年来自奥斯陆饮食与戒烟研究（Oslo Diet and Antismoking Study）的高脂血症高危受试者（n=563）在 25 年后接受重新检查，并在 1997 年被随机分配到一项新的为期 3 年的前瞻性 2x2 析因安慰剂对照研究中，研究内容为 n-3 多不饱和脂肪酸和/或饮食咨询。在 25 年随访时收集了医院焦虑抑郁量表（Hospital Anxiety and Depression Scale，HADS）、生活满意度指数（Life Satisfaction Index，LSI）以及一项新的关于健康关注和对风险信息的反应行为的问卷。在 505 名受试者完成为期 3 年的动脉粥样硬化饮食与欧米伽 3 干预试验（Diet and Omega-3 Intervention Trial on Atherosclerosis，DOIT）后，评估了 HADS 焦虑和 LSI。
在筛查计划 25 年后，HADS 焦虑与挪威常模相似（3.3 vs. 3.5），而 HADS 抑郁显著降低（3.6 vs. 4.1，P<.01）。患者报告称，25 年的高脂血症意识通过适度改变饮食习惯、限制一些生活行为，改善了整体生活状况，从而影响了健康关注。在 DOIT 中的一项新的 3 年干预后，饮食咨询组和对照组在焦虑、抑郁或生活满意度方面没有差异，但两组的 HADS 焦虑均显著增加（4.0 vs. 3.3，P<.001）。
与一般人群相比，筛查阳性受试者在筛查 25 年后没有增加心理困扰，有益的健康行为持续存在。饮食咨询并未影响心理社会结局。
