Jones Salene M W, Salem Rana, Amtmann Dagmar
Int J MS Care. 2018 May-Jun;20(3):145-152. doi: 10.7224/1537-2073.2017-069.
People with multiple sclerosis (MS) are at increased risk for depression and anxiety. The symptoms of MS are often similar to the somatic or physical symptoms of depression and anxiety (fatigue, trouble concentrating). This study examined whether MS symptoms and effects biased the assessment of somatic symptoms of anxiety and depression.
People with MS (n = 513) completed a survey about MS symptoms, treatments, and distress. The Patient Health Questionnaire-9 assessed depression, and the patient-report version of the Primary Care Evaluation of Mental Disorders assessed anxiety. Participants were grouped into low versus high MS symptoms based on self-reported symptoms and as high versus low disability by the Expanded Disability Status Scale (EDSS). Groups were compared using differential item functioning analysis.
No bias was found on somatic symptoms of depression comparing high versus low MS symptom groups (P > .15) or comparing groups based on EDSS scores (P > .29). Two anxiety symptoms (fatigue and muscle tension) showed bias comparing high versus low MS symptom groups (P < .01) and comparing high versus low groups based on EDSS scores (P ≤ .01). Intraclass correlations suggested a small effect due to bias in the somatic symptoms of anxiety.
Somatic symptoms of depression are unlikely to be biased by MS symptoms. However, the use of certain somatic symptoms to assess anxiety may be biased for those with high MS symptoms.
多发性硬化症（MS）患者患抑郁症和焦虑症的风险增加。MS的症状通常与抑郁和焦虑的躯体或身体症状相似（疲劳、注意力不集中）。本研究调查了MS症状和影响是否会使焦虑和抑郁的躯体症状评估产生偏差。
MS患者（n = 513）完成了一项关于MS症状、治疗和痛苦的调查。患者健康问卷-9评估抑郁，精神障碍初级保健评估的患者报告版本评估焦虑。根据自我报告的症状将参与者分为MS症状低组和高组，并根据扩展残疾状态量表（EDSS）分为高残疾组和低残疾组。使用差异项目功能分析对组进行比较。
在比较MS症状高组和低组（P > 0.15）或根据EDSS评分比较组时（P > 0.29），未发现抑郁的躯体症状存在偏差。在比较MS症状高组和低组时（P < 0.01）以及根据EDSS评分比较高组和低组时（P ≤ 0.01），两种焦虑症状（疲劳和肌肉紧张）显示出偏差。组内相关性表明，焦虑的躯体症状偏差产生的影响较小。
抑郁的躯体症状不太可能因MS症状而产生偏差。然而，对于MS症状高的患者，使用某些躯体症状来评估焦虑可能会产生偏差。
