Johansson Sverker, Gottberg Kristina, Kierkegaard Marie, Ytterberg Charlotte
Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-141 83, Huddinge, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
BMC Neurol. 2016 Mar 5;16:32. doi: 10.1186/s12883-016-0551-1.
There is limited knowledge regarding how depressive symptoms and a cluster of specific mood symptoms in people with multiple sclerosis (MS) vary over time and how they are influenced by contributing factors. Therefore, the aims of this study were a) to describe variations over 2 years in the occurrence of depressive symptoms and mood symptoms in a sample of people with MS, and b) to investigate the predictive value of sex, age, coping capacity, work status, disease severity, disease course, fatigue, cognition, frequency of social/lifestyle activities, and perceived impact of MS on health, on the occurrence of depressive symptoms and mood symptoms.
Through using a protocol of measures of functioning and perceived impact of MS on health, comprising of the Beck Depression Inventory, 219 people with MS were assessed at 0, 12 and 24 months. Predictive values were explored with Generalised Estimating Equations.
Proportions with depressive symptoms varied significantly (p < 0.001) from 21 to 30% between the three time points. Proportions with mood symptoms varied significantly (p < 0.001) from 14 to 17% between the three time points. Weak coping capacity and reduced frequency of social/lifestyle activities predicted the occurrence of depressive symptoms and mood symptoms, as did the psychological impact of MS on health in interaction with time. For people with MS of working age, not working predicted the occurrence of depressive symptoms and mood symptoms, as did the physical impact of MS on health on the occurrence of mood symptoms.
The occurrence of depressive symptoms and mood symptoms in people with MS vary over a 2-year time period; almost half have depressive symptoms at least once. Health care services should develop strategies aimed at identifying people with MS who are depressed or who develop depressive symptoms. Interventions for alleviating depressive symptoms should consider the individual's coping capacity and perceived impact of MS on health, and facilitate their ability to maintain participation in valued everyday activities.
关于多发性硬化症（MS）患者的抑郁症状和一系列特定情绪症状如何随时间变化以及它们如何受到影响因素的影响，目前所知有限。因此，本研究的目的是：a）描述MS患者样本中抑郁症状和情绪症状在两年内的变化情况；b）调查性别、年龄、应对能力、工作状态、疾病严重程度、病程、疲劳、认知、社交/生活方式活动频率以及MS对健康的感知影响对抑郁症状和情绪症状发生的预测价值。
通过使用一套MS功能和对健康感知影响的测量方案，其中包括贝克抑郁量表，对219名MS患者在0、12和24个月时进行评估。使用广义估计方程探索预测价值。
三个时间点之间，有抑郁症状的比例从21%到30%有显著差异（p < 0.001）。有情绪症状的比例在三个时间点之间从14%到17%有显著差异（p < 0.001）。应对能力弱和社交/生活方式活动频率降低预测了抑郁症状和情绪症状的发生，MS对健康的心理影响与时间的交互作用也有此预测作用。对于处于工作年龄的MS患者，不工作预测了抑郁症状和情绪症状的发生，MS对健康的身体影响对情绪症状的发生也有此预测作用。
MS患者的抑郁症状和情绪症状在两年时间内会发生变化；几乎一半的患者至少有一次抑郁症状。医疗保健服务应制定策略，旨在识别出患有抑郁症或出现抑郁症状的MS患者。缓解抑郁症状的干预措施应考虑个体的应对能力和MS对健康的感知影响，并促进他们保持参与有价值的日常活动的能力。
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