McKay Kyla A, Tremlett Helen, Fisk John D, Patten Scott B, Fiest Kirsten, Berrigan Lindsay, Marrie Ruth Ann
Department of Neurology, Faculty of Medicine, University of British Columbia, Canada.
Departments of Psychiatry, Psychology, & Neuroscience, Dalhousie University, Canada.
Mult Scler. 2016 Apr;22(5):685-93. doi: 10.1177/1352458515599073. Epub 2015 Aug 5.
Depression and anxiety are common among people with multiple sclerosis (MS), as are adverse health behaviours, but the associations between these factors are unclear.
To evaluate the associations between cigarette smoking, alcohol use, and depression and anxiety in MS in a cross-Canada prospective study.
From July 2010 to March 2011 we recruited consecutive MS patients from four MS clinics. At three visits over two years, clinical and demographic information was collected, and participants completed questionnaires regarding health behaviours and mental health.
Of 949 participants, 75.2% were women, with a mean age of 48.6 years; most had a relapsing-remitting course (72.4%). Alcohol dependence was associated with increased odds of anxiety (OR: 1.84; 95% CI: 1.32-2.58) and depression (OR: 1.53; 95% CI: 1.05-2.23) adjusting for age, sex, Expanded Disability Status Scale (EDSS), and smoking status. Smoking was associated with increased odds of anxiety (OR: 1.29; 95% CI: 1.02-1.63) and depression (OR: 1.37; 95% CI: 1.04-1.78) adjusting for age, sex, EDSS, and alcohol dependence. Alcohol dependence was associated with an increased incidence of depression but not anxiety. Depression was associated with an increased incidence of alcohol dependence.
Alcohol dependence and smoking were associated with anxiety and depression. Awareness of the effects of adverse health behaviours on mental health in MS might help target counselling and support for those 'at risk'.
抑郁症和焦虑症在多发性硬化症（MS）患者中很常见，不良健康行为也是如此，但这些因素之间的关联尚不清楚。
在一项加拿大全国性前瞻性研究中，评估吸烟、饮酒与MS患者的抑郁和焦虑之间的关联。
2010年7月至2011年3月，我们从四家MS诊所连续招募MS患者。在两年内的三次就诊中，收集了临床和人口统计学信息，参与者完成了关于健康行为和心理健康的问卷调查。
在949名参与者中，75.2%为女性，平均年龄48.6岁；大多数患者病程为复发缓解型（72.4%）。在调整年龄、性别、扩展残疾状态量表（EDSS）和吸烟状况后，酒精依赖与焦虑（比值比：1.84；95%置信区间：1.32 - 2.58）和抑郁（比值比：1.53；95%置信区间：1.05 - 2.23）的几率增加相关。在调整年龄、性别、EDSS和酒精依赖后，吸烟与焦虑（比值比：1.29；95%置信区间：1.02 - 1.63）和抑郁（比值比：1.37；95%置信区间：1.04 - 1.78）的几率增加相关。酒精依赖与抑郁发病率增加相关，但与焦虑无关。抑郁与酒精依赖发病率增加相关。
酒精依赖和吸烟与焦虑和抑郁相关。认识到不良健康行为对MS患者心理健康的影响，可能有助于针对“高危”人群开展咨询和支持。
