Nsamenang Sheri A, Hirsch Jameson K, Topciu Raluca, Goodman Andrew D, Duberstein Paul R
McMaster Childrens Hospital, Hamilton Health Sciences, Hamilton, Canada.
Department of Psychology, East Tennessee State University, 420 Rogers Stout Hall, Johnson City, TN, 37614, USA.
J Behav Med. 2016 Apr;39(2):355-63. doi: 10.1007/s10865-016-9712-3. Epub 2016 Jan 22.
Depressive symptoms are common in individuals with multiple sclerosis (MS), and are frequently exacerbated by pain; however, spiritual well-being may allow persons with MS to more effectively cope with pain-related deficits in physical and role functioning. We explored the associations between spiritual well-being, pain interference and depressive symptoms, assessing each as a potential mediator, in eighty-one patients being treated for MS, who completed self-report measures: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale, Pain Effects Scale, and Center for Epidemiologic Studies Depression Scale Revised. At the bivariate level, spiritual well-being and its subscale of meaning and peace were negatively associated with depression and pain interference. In mediation models, depression was not related to pain interference via spiritual well-being, or to spiritual well-being via pain interference. Pain interference was related to depression via spiritual well-being and meaning/peace, and to spiritual well-being and meaning/peace via depressive symptoms. Finally, spiritual well-being and meaning/peace were related to depression via pain interference, and to pain interference via depressive symptoms. For patients with MS, a multi-faceted approach to treatment that includes pain reduction and promotion of spiritual well-being may be beneficial, although amelioration of depression remains a critical task.
抑郁症状在多发性硬化症（MS）患者中很常见，且常因疼痛而加重；然而，精神健康状况良好可能使MS患者更有效地应对与疼痛相关的身体机能和角色功能缺陷。我们在81名接受MS治疗的患者中探讨了精神健康状况、疼痛干扰与抑郁症状之间的关联，并将每一项作为潜在中介因素进行评估，这些患者完成了自我报告测量：慢性病治疗功能评估-精神健康状况量表、疼痛影响量表和流行病学研究中心抑郁量表修订版。在双变量水平上，精神健康状况及其意义与安宁子量表与抑郁和疼痛干扰呈负相关。在中介模型中，抑郁与通过精神健康状况产生的疼痛干扰无关，也与通过疼痛干扰产生的精神健康状况无关。疼痛干扰通过精神健康状况和意义/安宁与抑郁相关，通过抑郁症状与精神健康状况和意义/安宁相关。最后，精神健康状况和意义/安宁通过疼痛干扰与抑郁相关，通过抑郁症状与疼痛干扰相关。对于MS患者，一种包括减轻疼痛和促进精神健康状况的多方面治疗方法可能是有益的，尽管改善抑郁仍然是一项关键任务。
