Labiano-Fontcuberta Andrés, Mitchell Alex J, Moreno-García Sara, Benito-León Julián
Department of Neurology University Hospital "12 de Octubre", Madrid, Spain.
Department of Psycho-oncology, Leicestershire Partnership Trust and University of Leicester, Leicester, UK.
J Neurol Sci. 2015 Feb 15;349(1-2):220-5. doi: 10.1016/j.jns.2015.01.024. Epub 2015 Jan 26.
Multiple sclerosis (MS) patients have high rates of complications and disability, including cognitive impairment, that often, impact on caregivers' emotional health. Clarification may help identify improved supportive strategies for both caregivers and patients.
We aimed to analyse whether MS domain-specific cognitive impairment can influence the severity of psychiatric symptoms of MS caregivers.
Patients with definite MS (n=63) and their corresponding caregivers (n=63) were recruited. In addition, 59 matched controls were enrolled for establishing normative cognitive data. Each patient underwent a complete neuropsychological testing for cognitive impairment and thorough clinical assessment, including data of disability status (EDSS), affective and emotional symptoms (depression, anxiety, anger) and fatigue. Psychiatric symptoms of the caregivers were assessed with the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI).
In logistic regression analyses, even after controlling for other MS-related symptoms, cognitive deficits, namely impairment on Symbol Digit Modalities Test (OR=8.03, 95% CI=1.27-25.33, p=0.027) and on the Paced Auditory Serial Addition Test (OR=6.86, 95% CI=1.07-21.97, p=0.042), were significant and independent predictors of more severe caregivers' depressive symptoms.
Information processing speed impairment is independently associated with more severe depressive symptoms of caregivers of MS patients, thereby reflecting a further deterioration of family setting.
多发性硬化症（MS）患者出现并发症和残疾的几率很高，包括认知障碍，这常常会影响照顾者的情绪健康。弄清楚这一点可能有助于为照顾者和患者确定更好的支持策略。
我们旨在分析MS特定领域的认知障碍是否会影响MS患者照顾者精神症状的严重程度。
招募了确诊为MS的患者（n = 63）及其相应的照顾者（n = 63）。此外，还纳入了59名匹配的对照者以建立认知规范数据。每位患者都接受了全面的神经心理学测试以评估认知障碍，并进行了全面的临床评估，包括残疾状态数据（扩展残疾状态量表）、情感和情绪症状（抑郁、焦虑、愤怒）以及疲劳情况。使用贝克焦虑量表（BAI）和贝克抑郁量表（BDI）评估照顾者的精神症状。
在逻辑回归分析中，即使在控制了其他与MS相关的症状后，认知缺陷，即符号数字模式测验得分降低（比值比[OR]=8.03，95%置信区间[CI]=1.27 - 25.33，p = 0.027）和听觉连续加法测验得分降低（OR = 6.86，95% CI = 1.07 - 21.97，p = 0.042），仍是照顾者抑郁症状更严重的显著且独立预测因素。
信息处理速度受损与MS患者照顾者更严重的抑郁症状独立相关，从而反映出家庭环境的进一步恶化。
