Elfferich M D P, De Vries J, Drent M
Dept of Physical Therapy, Maastricht University Medical Centre (MUMC), the Netherlands.
Sarcoidosis Vasc Diffuse Lung Dis. 2011 Jul;28(1):65-71.
Personality factors have shown to be related to mortality, morbidity, and psychological aspects in chronic disorders. Little is known about the effect of personality on disease severity in sarcoidosis and idiopathic pulmonary fibrosis (IPF). The aim of this study was to assess the prevalence of Type D personality and its relation with relevant clinical characteristics in sarcoidosis and IPF patients.
The study included 441 sarcoidosis and 49 IPF patients from the outpatient clinic of the ild care team of the MUMC, the Netherlands. They completed the DS14 (Type D questionnaire), the fatigue assessment scale (FAS), the WHO quality of life-BREF (WHOQOL-BREF) and the Centre for Epidemiological Studies-Depression Scale (CES-D). Moreover, relevant clinical data were collected. The control group consisted of 3678 subjects from a general population.
Type D personality was found in 25.6% of the sarcoidosis patients compared to 21% in the controls, but only in 18.8% of the IPF patients. No relation with disease severity was found in either of these disorders. Fatigue was a substantial problem in both populations. Depressive symptoms but not Type D personality predicted fatigue and poorer QOL in sarcoidosis and IPF.
Prevalence of Type D personality is not higher in sarcoidosis and IPF patients than in the general population and does not explain QOL impairment. Depressive symptoms explain QOL impairment and fatigue substantially. Therefore, in the multidisciplinary management of sarcoidosis and IPF psychological screening and psychological counselling concerning adequate coping strategies should be incorporated.
人格因素已被证明与慢性疾病的死亡率、发病率及心理方面有关。关于人格对结节病和特发性肺纤维化(IPF)疾病严重程度的影响知之甚少。本研究的目的是评估D型人格在结节病和IPF患者中的患病率及其与相关临床特征的关系。
该研究纳入了来自荷兰马斯特里赫特大学医学中心间质性肺病护理团队门诊的441例结节病患者和49例IPF患者。他们完成了DS14(D型问卷)、疲劳评估量表(FAS)、世界卫生组织生活质量简表(WHOQOL - BREF)和流行病学研究中心抑郁量表(CES - D)。此外,还收集了相关临床数据。对照组由3678名普通人群组成。
结节病患者中25.6%为D型人格,对照组为21%,而IPF患者中仅18.8%为D型人格。在这两种疾病中均未发现与疾病严重程度有关。疲劳在这两个人群中都是一个严重问题。抑郁症状而非D型人格可预测结节病和IPF患者的疲劳及较差的生活质量。
结节病和IPF患者中D型人格的患病率并不高于普通人群,也不能解释生活质量受损情况。抑郁症状可很大程度上解释生活质量受损和疲劳情况。因此,在结节病和IPF的多学科管理中,应纳入心理筛查及关于适当应对策略的心理咨询。