Department of Neurology, Neuroimmunological Section, University of Rostock, Rostock, Germany.
Department of Neurology, Medical University of Vienna, Vienna, Austria.
CNS Neurosci Ther. 2018 Sep;24(9):784-789. doi: 10.1111/cns.12857. Epub 2018 Apr 10.
Treatment options for multiple sclerosis (MS) have enlarged tremendously over the last years. Nonetheless, lots of patients look for alternative treatment options. The use of complementary and alternative medicine (CAM) is widespread in MS, however, its scientific investigation is limited so far. The aim of the study is to analyse clinical and demographical differences of MS patients in dependency of their CAM utilization as coping strategy.
A total of 254 patients with a clinically definite MS were examined in a semistructured interview. Additional standardized questionnaires were used to measure different aspects of coping with illness. All patients underwent neurological examination.
About 206 of all enrolled patients are CAM users (81.1%). They have a longer disease duration (8.3 years vs 7.3 years, P = 0.028) and show higher disability (median EDSS 4.0 vs 2.0, P < 0.001) than nonusers. CAM users differed significantly from nonusers in their coping behavior (P = 0.035). Users are brooding more heavily over the disease, looking for more information about MS, and are looking for a sense of their disease in religion more often than nonusers. CAM users are at a higher risk of depression. Almost two-thirds of CAM users (57.6%) reported positive effects on the well-being of their state of health.
Coping behavior differs significantly between CAM users and nonusers. CAM utilization is associated with higher disability and depression. More than 80% of our cohort has used alternative or complementary methods. CAM utilization may mirror unmet needs in the treatment of MS.
近年来,多发性硬化症(MS)的治疗选择大大增加。尽管如此,许多患者仍在寻找替代治疗方案。在 MS 中,补充和替代医学(CAM)的应用非常广泛,但迄今为止,其科学研究仍很有限。本研究的目的是分析 MS 患者在使用 CAM 作为应对策略时的临床和人口统计学差异。
在半结构化访谈中对 254 名经临床确诊的 MS 患者进行了检查。使用额外的标准化问卷来测量不同方面的疾病应对情况。所有患者均接受了神经系统检查。
所有入组患者中约有 206 名(81.1%)是 CAM 用户。他们的疾病病程更长(8.3 年 vs 7.3 年,P=0.028),残疾程度更高(中位数 EDSS 4.0 vs 2.0,P<0.001)。CAM 用户与非用户在应对行为上存在显著差异(P=0.035)。使用者对疾病的担忧更严重,更频繁地寻找有关 MS 的信息,并且更频繁地从宗教中寻找疾病的意义。CAM 用户患抑郁症的风险更高。近三分之二的 CAM 用户(57.6%)报告称,CAM 对他们的健康状况和幸福感有积极影响。
CAM 用户和非用户的应对行为存在显著差异。CAM 的应用与更高的残疾和抑郁风险相关。我们队列中的超过 80%的患者已经使用了替代或补充方法。CAM 的应用可能反映了 MS 治疗中未满足的需求。