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神经退行性疾病的症状前检测:中至长期的心理病理学影响。

Pre-symptomatic testing for neurodegenerative disorders: Middle- to long-term psychopathological impact.

机构信息

Universidade do Porto (Portugal).

出版信息

Psicothema. 2017 Nov;29(4):446-452. doi: 10.7334/psicothema2016.298.

Abstract

BACKGROUND

Over the past 20 years, studies have revealed that the communication of a pre-symptomatic test (PST) result for late-onset diseases, such as Huntington’s disease (HD), doesn’t cause psychological disturbance. This cross-sectional study investigated the middle- (4 years) to long-term (7 and 10 years) psychological impact of PST for 3 autosomal dominant late-onset diseases: HD, Machado-Joseph disease (DMJ) and familial amyloid polyneuropathy (FAP).

METHOD

The study included 203 subjects: 170 (84%) agreed to make the PST for FAP, 29 (14%) for HD and 4 (2%) for MJD. They were mostly women (58%) and married (67%). It was considered the cutoffs points: 4 years (middle-term) and 7 and 10 years (long-term) indicating the time after receiving the TPS results.

RESULTS

women and widows (oldest) presented the highest mean values for almost all BSI dimensions and the highest values correspond to the obsessive-compulsive dimension. MJD participants presented the highest mean values. No differences were found concerning the PST test results while participants are still asymptomatic. Psychopathology was only present in symptomatic carriers.

CONCLUSIONS

The onset of the disease seems to assume the trigger for psychological disturbance, regardless the time that has elapsed since the PST result communication or the individual carrier/non-carrier condition.

摘要

背景

在过去的 20 年中,研究表明,对迟发性疾病(如亨廷顿病(HD))进行症状前检测(PST)结果的沟通并不会引起心理困扰。本横断面研究调查了 PST 对三种常染色体显性迟发性疾病(HD、Machado-Joseph 病(DMJ)和家族性淀粉样多神经病(FAP))的中(4 年)至长(7 年和 10 年)期心理影响。

方法

该研究纳入了 203 名受试者:170 名(84%)同意进行 FAP 的 PST,29 名(14%)同意进行 HD 的 PST,4 名(2%)同意进行 MJD 的 PST。他们大多是女性(58%)和已婚(67%)。考虑到以下时间点:4 年(中期)和 7 年和 10 年(长期),表明在收到 PST 结果后时间。

结果

女性和寡妇(年龄最大)在几乎所有 BSI 维度上的平均值最高,最高值与强迫性维度相对应。MJD 参与者的平均值最高。在参与者仍无症状时,对于 PST 测试结果没有差异。精神病理学仅存在于有症状的携带者中。

结论

疾病的发作似乎是心理困扰的触发因素,而与 PST 结果沟通后的时间长短或个体携带者/非携带者状态无关。

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