National Multiple Sclerosis Foundation, Wagenstraat 25, 3142 CR Maassluis, The Netherlands.
J Neurol Sci. 2012 Sep 15;320(1-2):85-90. doi: 10.1016/j.jns.2012.06.023. Epub 2012 Jul 15.
There is growing evidence for the association between stress and relapse risk in multiple sclerosis (MS). The current study focuses on daily hassles, which by their chronic and accumulating nature can cause considerable psychosocial stress. The main aim was to investigate the frequency, associated distress and type of daily hassles encountered by Dutch MS patients from a large community-based sample. We further examined factors associated with high levels of psychosocial stress. Questionnaires concerning demographics, disease characteristics, physical functioning, daily hassles, fatigue, depression and anxiety were completed by 718 MS patients. Three patients younger than 18 were excluded, resulting in 715 patients. Compared with published norm data, more than 50% of the participants reported a high number of daily hassles (57.5%) and high levels of associated distress (55.7%). Frequently mentioned daily hassles concern personal functioning and social developments. A logistic regression model revealed that being female, being younger, having a higher educational level, using benzodiazepines, exhibiting more symptoms of anxiety, and a higher physical impact of fatigue were all independently associated with high levels of psychosocial stress. Our findings may alert clinicians of the high prevalence and impact of daily hassles in MS and underline the need to incorporate stress and anxiety management strategies in (psycho)therapeutic interventions.
越来越多的证据表明,压力与多发性硬化症(MS)的复发风险之间存在关联。本研究侧重于日常困扰,由于其慢性和累积的性质,日常困扰可能会导致相当大的心理社会压力。主要目的是调查来自大型基于社区的样本的荷兰多发性硬化症患者所经历的日常困扰的频率、相关痛苦和类型。我们进一步研究了与高水平心理社会压力相关的因素。718 名 MS 患者完成了关于人口统计学、疾病特征、身体功能、日常困扰、疲劳、抑郁和焦虑的问卷。排除了 3 名年龄小于 18 岁的患者,最终纳入 715 名患者。与已发表的常模数据相比,超过 50%的参与者报告了大量的日常困扰(57.5%)和高度相关的困扰(55.7%)。经常提到的日常困扰涉及个人功能和社会发展。逻辑回归模型显示,女性、年轻、受教育程度高、使用苯二氮䓬类药物、焦虑症状更多以及疲劳对身体的影响更大,这些都是与高水平心理社会压力独立相关的因素。我们的研究结果可能会提醒临床医生注意多发性硬化症中日常困扰的高发生率和影响,并强调需要在(心理)治疗干预中纳入压力和焦虑管理策略。