Ondokuz Mayis University School of Medicine Samsun/Turkey.
Gen Hosp Psychiatry. 2013 Mar-Apr;35(2):134-40. doi: 10.1016/j.genhosppsych.2012.10.011. Epub 2012 Dec 21.
This study was intended to identify general psychiatric symptoms in multiple sclerosis (MS) patients and to determine the distribution of these psychiatric symptoms by type of MS and degree of disability.
One hundred fifty-two volunteers, 76 MS patients and 76 healthy controls, matched in terms of age, gender, marital status, years spent in education and income, were included. Psychiatric symptoms were measured using the Symptom Checklist-90-R, Beck Depression Inventory, State-Trait Anxiety Inventory, Pittsburgh Sleep Quality Index, Padua Inventory, Rosenberg Self-Esteem Scale and Eating Attitude Test. Degree of disability was determined using the Expanded Disability Status Scale (EDSS). In addition to being compared between the patient and control groups, scale scores were also compared between groups established on the basis of relapsing-remitting or progressive forms of MS, neurological disability and ambulatory ability. Correlations were determined between EDSS scores and psychiatric scale scores.
In addition to symptoms of depression, anxiety and sleep impairment in MS patients, we also determined that less studied symptoms such as somatization, obsession, compulsion, interpersonal sensitivity, anger-hostility, phobic anxiety, paranoid ideation, psychoticism, low self-esteem and distorted eating attitudes were also more frequent compared to the healthy controls. Some symptoms were also more prevalent in progressive MS patients compared to relapsing-remitting subjects. Symptoms increase as degree of disability rises and ambulatory capacity declines.
Depressive, anxious and sleep impairment symptoms are not the only ones seen in MS patients; other psychiatric symptoms are also common. Further studies are needed to investigate the frequency and causes of these little-investigated symptoms. As seen in patients with a progressive course and greater neurological disability, more psychiatric symptoms develop in patients with more severe disease.
本研究旨在识别多发性硬化症（MS）患者的一般精神症状，并确定这些精神症状的分布与 MS 类型和残疾程度有关。
共纳入 152 名志愿者，76 名 MS 患者和 76 名健康对照者，按年龄、性别、婚姻状况、受教育年限和收入相匹配。使用症状清单-90-R、贝克抑郁量表、状态-特质焦虑量表、匹兹堡睡眠质量指数、帕多瓦量表、罗森伯格自尊量表和饮食态度测试来测量精神症状。使用扩展残疾状态量表（EDSS）来确定残疾程度。除了在患者组和对照组之间进行比较外，我们还根据复发缓解或进行性 MS、神经残疾和步行能力建立的组，比较了量表评分。确定了 EDSS 评分与精神科量表评分之间的相关性。
除了 MS 患者的抑郁、焦虑和睡眠障碍症状外，我们还发现，与健康对照组相比，躯体化、强迫观念、强迫行为、人际敏感、愤怒敌意、恐怖焦虑、偏执观念、精神病态、自尊低下和饮食态度扭曲等研究较少的症状也更为常见。与复发缓解患者相比，进行性 MS 患者的某些症状也更为常见。症状随着残疾程度的增加和步行能力的下降而增加。
抑郁、焦虑和睡眠障碍症状并不是 MS 患者独有的；其他精神症状也很常见。需要进一步研究来调查这些研究较少的症状的频率和原因。正如进展性病程和更大神经残疾的患者所见，病情更严重的患者会出现更多的精神症状。
