Ron M A, Logsdail S J
National Hospital for Nervous Diseases, London.
Psychol Med. 1989 Nov;19(4):887-95. doi: 10.1017/s0033291700005602.
This study reports the psychiatric morbidity in 116 patients with definite multiple sclerosis (MS). The presence of brain pathology was investigated using magnetic resonance imaging (MRI). A group of 48 physically disabled controls suffering from rheumatic or neurological conditions not involving the brain was used for comparison. Normative MRI data were obtained from a group of 40 healthy volunteers. Psychiatric morbidity was significantly higher in the MS group with nearly half of the patients scoring as cases at interview. There was no evidence to suggest that psychiatric symptoms in isolation were the first manifestation of MS in the present material. The presence of psychiatric illness at interview was significantly related to the degree of social stress as perceived by the patient. The severity of MRI abnormalities was greater in those with longer histories and greater physical disability, but did not show a significant relationship with global measures of psychiatric disability. Of the various psychiatric symptoms elation was significantly correlated with the presence of widespread MRI abnormalities, while flattening of affect, delusions and thought disorder correlated with the degree of pathology in the temporo-parietal region.
本研究报告了116例确诊为多发性硬化症（MS）患者的精神疾病发病率。使用磁共振成像（MRI）研究脑部病变的存在情况。选取了一组48名患有不涉及脑部的风湿性或神经疾病的身体残疾对照者进行比较。从一组40名健康志愿者那里获取了MRI规范数据。MS组的精神疾病发病率显著更高，近一半的患者在访谈中被评定为病例。在本研究材料中，没有证据表明单独的精神症状是MS的首发表现。访谈时精神疾病的存在与患者所感知到的社会压力程度显著相关。MRI异常的严重程度在病程较长和身体残疾程度较高的患者中更大，但与精神残疾的总体指标没有显著关系。在各种精神症状中，欣快与广泛的MRI异常显著相关，而情感平淡、妄想和思维障碍与颞顶叶区域的病变程度相关。
