Fernández-Jiménez E, Pérez-San-Gregorio M A, Martín-Rodríguez A, Pérez-Bernal J, Gómez-Bravo M A
Faculty of Psychology, Department of Personality, Assessment, and Psychological Treatment, University of Seville, Spain.
Faculty of Psychology, Department of Personality, Assessment, and Psychological Treatment, University of Seville, Spain.
Transplant Proc. 2015 Jan-Feb;47(1):104-6. doi: 10.1016/j.transproceed.2014.11.015.
We aimed to compare the affective symptomatology in two medical conditions under immunotherapy (cadaveric liver transplantation [G1] and multiple sclerosis [G2]), considering their functional impairment, and to assess the clinical significance of the results regarding a representative age-adjusted sample of the general Spanish population (G3).
Using a cross-sectional design, 164 patients (82 per clinical group) were selected, matched for gender, and homogenized regarding age and functional impairment according to the Physical functioning subscale from the SF-36 Health Survey. The criterion variables were the Mental health and Role-emotional SF-36 subscales and the Hospital Anxiety and Depression Scale. An analysis of covariance was conducted, controlling for age and the Physical functioning score as covariates. Cohen's d was reported as an effect size index and to analyze the clinical significance regarding a representative age-adjusted sample of the general Spanish population (n = 7881).
No statistically significant differences were found between conditions in any affective dimension (P > .05; ds₁₋₂ from 0.08 to 0.30) or in the percentage of clinical cases regarding the anxious (P = .628) or depressive spectrum (P = .716). The neurological patients showed clinically significant impairment in both SF-36 subscales (ds₂₋₃ = 0.55 and 0.52, respectively), but transplant recipients only differed from the general population in Role-emotional (d₁₋₃ = 0.81).
Despite having controlled for functional impairment, important deterioration in daily functioning was still found in liver recipients due to emotional problems, and no relevant differences were observed even when compared with a neurodegenerative condition such as multiple sclerosis.
我们旨在比较接受免疫治疗的两种疾病（尸体肝移植[G1]和多发性硬化症[G2]）中的情感症状学，考虑它们的功能损害，并评估针对西班牙普通人群代表性年龄调整样本（G3）的结果的临床意义。
采用横断面设计，选取164例患者（每个临床组82例），根据性别进行匹配，并根据SF-36健康调查的身体功能分量表在年龄和功能损害方面进行同质化处理。标准变量为心理健康和角色情绪SF-36分量表以及医院焦虑抑郁量表。进行协方差分析，将年龄和身体功能得分作为协变量进行控制。报告Cohen's d作为效应大小指标，并分析针对西班牙普通人群代表性年龄调整样本（n = 7881）的临床意义。
在任何情感维度上，两种疾病之间均未发现统计学上的显著差异（P >.05；d₁₋₂从0.08至0.30），在焦虑（P =.628）或抑郁谱（P =.716）的临床病例百分比方面也未发现差异。神经疾病患者在两个SF-36分量表上均表现出临床显著损害（ds₂₋₃分别为0.55和0.52），但移植受者仅在角色情绪方面与普通人群存在差异（d₁₋₃ = 0.81）。
尽管对功能损害进行了控制，但肝移植受者仍因情感问题在日常功能方面出现了重要的恶化，即使与诸如多发性硬化症这样的神经退行性疾病相比，也未观察到相关差异。
