Possa M F, Minacapelli E, Canale S, Comi G, Martinelli V, Falautano M
a Psychology and Neuropsychology Service, Department of Neurology , San Raffaele Scientific Institute , Milan , Italy.
b Psychological Service, Department of Neurorehabilitation , MultiMedica , Limbiate , Italy.
Psychol Health Med. 2017 Oct;22(9):1063-1071. doi: 10.1080/13548506.2016.1274043. Epub 2017 Jan 6.
The impact of multiple sclerosis (MS) diagnosis on newly diagnosed individuals remains so far little explored. Our aim is to outline affective, personality and quality of life (QoL) correlates of MS patients shortly after MS diagnosis. Thirty-eight (22 F and 16 M) newly-diagnosed MS patients (mean interval from diagnosis communication 4.7 ± 3.8 months, range 1-12 months) underwent the Montgomery-Åsberg Depression Rating Scale and a comprehensive psychological evaluation: Beck Depression Inventory-II, State-Trait Anxiety Inventory, Psychophysiological Questionnaire-Revised, Fear Survey Schedule, Maudsley Obsessional-Compulsive Questionnaire, Impact of Event Scale-Revised, Personal Meaning Questionnaire, Problem Solving Inventory and Multiple Sclerosis Quality of Life-54. The Expanded Disability Status Scale was assessed during the neurological examination. Depressive symptomatology, only partially related to disability, was observed in approximately 40% of patients. The prevalent approach to MS diagnosis was one of avoidance in 65.8% of cases. QoL reductions in self-perception and psychological well-being emerged, together with a peculiar perception of change in health that was not related to neurological disability. With regard to personality assessment, depressive personal meaning organization correlates inversely with important QoL measures. Newly-diagnosed patients go through a complex network of psychological changes still in the initial phases immediately after diagnosis. A thorough understanding of these adjusting aspects by the neurologist could be crucial in improving patients' QoL, participation in relevant disease decisions and adherence to pharmacological therapy.
到目前为止，多发性硬化症（MS）诊断对新确诊患者的影响鲜有人探究。我们的目的是概述MS患者在确诊后不久情感、个性和生活质量（QoL）之间的关联。38名（22名女性和16名男性）新确诊的MS患者（从诊断告知起的平均间隔时间为4.7±3.8个月，范围为1 - 12个月）接受了蒙哥马利 - 阿斯伯格抑郁评定量表和全面的心理评估：贝克抑郁量表第二版、状态 - 特质焦虑量表、修订版心理生理问卷、恐惧调查量表、莫兹利强迫问卷、修订版事件影响量表、个人意义问卷、问题解决量表和多发性硬化症生活质量 - 54。在神经学检查期间评估了扩展残疾状态量表。约40%的患者观察到抑郁症状，且仅部分与残疾相关。在65.8%的病例中，MS诊断的普遍应对方式是回避。自我认知和心理健康方面的生活质量出现下降，同时出现了一种与神经残疾无关的特殊健康变化认知。关于个性评估，抑郁的个人意义组织与重要的生活质量指标呈负相关。新确诊的患者在诊断后的初始阶段仍会经历复杂的心理变化网络。神经科医生对这些调整方面的透彻理解对于改善患者的生活质量、参与相关疾病决策以及坚持药物治疗可能至关重要。
