Carrigan Neil, Dysch Leon, Salkovskis Paul M
Department of Psychology,University of Bath,Claverton Down,Bath BA2 7AY.
Community Neuro and Stroke Service,St Martin's Hospital,Bath BA2 5RP.
Behav Cogn Psychother. 2018 Mar;46(2):148-167. doi: 10.1017/S135246581700056X. Epub 2017 Oct 9.
Multiple sclerosis (MS) is commonly associated with psychological complications. Previous research by Hayter and colleagues (2016) found that in patients with MS, health anxiety (HA) can account for part of the variance in quality of life (QoL) independent of physical and cognitive impairment caused by the disease. MS patients with HA perceived their intact physical and cognitive performance as impaired relative to those without HA and attributed the impairment to MS. These misperceptions might be useful targets in the treatment of HA in MS using cognitive behaviour therapy (CBT).
Study 1 sought to replicate the main findings from Hayter et al. (2016). Study 2 examined the impact of HA-focused CBT in a case series.
In Study 1, twenty participants with MS were screened for HA and assigned to either a high or low HA group. They completed assessments of cognitive and physical functioning before rating their performance on these tasks, followed by measures of QoL, mood and physical disability. Four participants in the high HA group subsequently received six sessions of CBT using a consecutive AB case series in Study 2.
Study 1 replicated the main findings from the earlier study. In Study 2, three of the four patients who received treatment showed substantial improvements in HA and mood and all showed improvement in QoL.
Given the high rates of HA in MS patients and its impact on QoL, this case series suggests that a brief CBT intervention could significantly improve patients' wellbeing.
多发性硬化症(MS)通常与心理并发症相关。海特及其同事(2016年)之前的研究发现,在MS患者中,健康焦虑(HA)可独立于该疾病所致的身体和认知损害,解释生活质量(QoL)差异的一部分。与无HA的MS患者相比,有HA的MS患者认为其完好的身体和认知表现受损,并将这种损害归因于MS。这些错误认知可能是采用认知行为疗法(CBT)治疗MS患者HA的有用靶点。
研究1旨在重复海特等人(2016年)的主要研究结果。研究2在一个病例系列中考察了以HA为重点的CBT的影响。
在研究1中,对20名MS患者进行HA筛查,并将其分为高HA组或低HA组。他们在对这些任务的表现进行评分之前,完成了认知和身体功能评估,随后进行了QoL、情绪和身体残疾测量。在研究2中,高HA组的4名参与者随后接受了连续6节的CBT治疗,采用连续AB病例系列。
研究1重复了早期研究的主要结果。在研究2中,接受治疗的4名患者中有3名在HA和情绪方面有显著改善,所有患者在QoL方面均有改善。
鉴于MS患者中HA的高发生率及其对QoL的影响,该病例系列表明,简短的CBT干预可显著改善患者的幸福感。