Lorefice Lorena, Fenu G, Trincas G, Moro M F, Frau J, Coghe G C, Cocco E, Marrosu M G, Carta M G
Department of Public Health and Clinical and Molecular Medicine, Multiple Sclerosis Center, University of Cagliari, Cagliari, Italy,
Neurol Sci. 2015 Sep;36(9):1625-31. doi: 10.1007/s10072-015-2220-3. Epub 2015 Apr 22.
Mood disorders are very common among multiple sclerosis (MS) patients, but their frequency in patients with progressive course (PMS) has not been adequately researched. Our study aimed to determine the frequency of mood disorders among patients with PMS compared with those with relapsing-remitting MS (RMS) and to explore the associations with disability and disease duration. The study included consecutive outpatients affected by MS according the 2010 revised Mc Donald diagnostic criteria. Psychiatric diagnoses were determined according to DSM-IV by psychiatrists using structured interview tools (ANTAS-SCID). Demographic and clinical data of patients were also collected. Disease courses were defined according to the re-examined phenotype descriptions by the Committee and MS Phenotype Group. Intergroup comparisons were performed by Chi-square test, while logistic regression analysis was performed to assess possible factors associated with mood disorders. In total, 240 MS patients (167 women) were enrolled; of these, 18 % (45/240) had PMS. The lifetime DSM-IV major depression diagnosis (MDD) was established in 40 and 23 % of the PMS and RMS patients, respectively. Using logistic regression analysis, the presence of MDD was independent from disease duration and disability and dependent on PMS course (P = 0.02; OR 2.2). Patients with PMS presented with MDD more frequently than those with RMS, independently from disease duration and physical disability. These findings highlight the importance of considering mood disorders, especially MDD, in the management of PMS patients.
情绪障碍在多发性硬化症（MS）患者中非常常见，但在病程为进展型（PMS）的患者中的发生率尚未得到充分研究。我们的研究旨在确定PMS患者与复发缓解型MS（RMS）患者相比情绪障碍的发生率，并探讨其与残疾程度和疾病持续时间的关联。该研究纳入了根据2010年修订的麦克唐纳诊断标准确诊为MS的连续门诊患者。精神科医生使用结构化访谈工具（ANTAS-SCID）根据《精神疾病诊断与统计手册》第四版（DSM-IV）确定精神科诊断。还收集了患者的人口统计学和临床数据。疾病病程根据委员会和MS表型组重新审查的表型描述来定义。组间比较采用卡方检验，同时进行逻辑回归分析以评估与情绪障碍相关的可能因素。总共招募了240名MS患者（167名女性）；其中，18%（45/240）为PMS患者。PMS和RMS患者中，终生DSM-IV重度抑郁症诊断（MDD）的比例分别为40%和23%。通过逻辑回归分析，MDD的存在与疾病持续时间和残疾程度无关，而与PMS病程有关（P = 0.02；OR = 2.2）。PMS患者比RMS患者更频繁地出现MDD，且与疾病持续时间和身体残疾无关。这些发现凸显了在PMS患者管理中考虑情绪障碍，尤其是MDD的重要性。
