Grabler Marvin R, Weyen Ute, Juckel Georg, Tegenthoff Martin, Mavrogiorgou-Juckel Paraskevi
Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital of Ruhr-University Bochum, Bochum, Germany.
Department of Neurology, Bergmannsheil University Hospital of Ruhr-University Bochum, Bochum, Germany.
Front Neurol. 2018 Dec 3;9:1035. doi: 10.3389/fneur.2018.01035. eCollection 2018.
Given the lethal severity of amyotrophic lateral sclerosis (ALS), the aim of this study was to illuminate the coherence of depression and death anxiety in both ALS patients and caregivers and in how far patients and caregivers are influenced by the mindset of their respective counterpart. 30 couples of patients (mean age 60.57; 13 women, 17 men) and primary caregivers (mean age 57.33; 16 women, 14 men) were included into the study. Death anxiety was assessed using the newly developed BOFRETTA scale, depression via Beck Depression Inventory, anxiety by means of State Trait Anxiety Inventory and caregivers' exertion using the Caregiver Strain Index. Patients' impairment was assessed with the ALS functional rating scale. We found that while death anxiety was related to depression in both patients and caregivers, death anxiety was related to anxiety only in patients. Caregiver strain correlated with both caregiver's depression and anxiety. Moreover, patients' and caregivers' depression, anxiety and death anxiety correlated to the ones of their counterpart. These results suggest that despite little depressive symptoms in ALS patients the fatal prognosis of the disease takes into account, depression and death anxiety influence each other and might be addressed together in pharmacological and especially psychotherapeutic interventions to the benefit of the patient. Medical professionals should not forget to offer sufficient support to caregivers tending patients affected by depression and death anxiety as they are likely to mirror their patient's feelings.
鉴于肌萎缩侧索硬化症(ALS)的致死严重性,本研究旨在阐明ALS患者及其照料者中抑郁与死亡焦虑之间的相关性,以及患者和照料者在多大程度上受到对方心态的影响。30对患者(平均年龄60.57岁;13名女性,17名男性)及其主要照料者(平均年龄57.33岁;16名女性,14名男性)被纳入本研究。使用新开发的BOFRETTA量表评估死亡焦虑,通过贝克抑郁量表评估抑郁,借助状态特质焦虑量表评估焦虑,并使用照料者压力指数评估照料者的压力。用ALS功能评定量表评估患者的功能障碍。我们发现,虽然患者和照料者的死亡焦虑均与抑郁相关,但仅患者的死亡焦虑与焦虑相关。照料者压力与照料者的抑郁和焦虑均相关。此外,患者和照料者的抑郁、焦虑及死亡焦虑与对方的相应情绪相关。这些结果表明,尽管ALS患者的抑郁症状较少,但考虑到该疾病的致命预后,抑郁和死亡焦虑相互影响,在药物治疗尤其是心理治疗干预中可能需要同时解决,以造福患者。医疗专业人员不应忘记为照料受抑郁和死亡焦虑影响患者的照料者提供充分支持,因为他们可能会反映其患者的感受。