National Research Centre for the Working Environment, Copenhagen, Denmark.
Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark.
BMC Psychiatry. 2019 Mar 4;19(1):84. doi: 10.1186/s12888-019-2066-y.
Several rating scales assessing stress-related symptoms of exhaustion have emerged in recent years. However, more knowledge is needed about the performance of these rating scales in patients with stress-related disorders as well as in other patient groups. With the recently developed Karolinska Exhaustion Disorder Scale (KEDS), we compared symptoms of exhaustion in different patient groups that were sorted according to diagnosis.
Patients were sampled consecutively from departments of occupational medicine (DOM) at three Danish hospitals. The total study group comprised 698 care-seeking patients (487 women). Patients with stress-related diagnoses (n = 217; the International Classification of Diseases [ICD]-10 code F43: reaction to severe stress and adjustment disorder) were compared to a diverse group of patients with a range of somatic diagnoses (n = 338) and to patients with other psychiatric diagnoses (n = 143), including subgroups with major depression disorder (n = 34; F32 and F33) and problems related to employment and unemployment (n = 99; Z56). The data were analysed using linear mixed models with the SPSS statistical program.
The mean KEDS sum score in patients with stress-related diagnoses (29.3; SD = 8.0) was significantly higher than in patients with other psychiatric diagnoses (25.9; SD = 9.5) and in patients with somatic diagnoses (17.6; SD = 10.8). The subgroup with a major depression disorder had high mean KEDS sum scores (31.4, SD = 8.1), similar to patients with stress-related diagnoses, while the mean KEDS sum score in patients with problems related to employment and unemployment (Z56) was 23.5 (SD = 9.0). Young and old patients scored similarly on KEDS, but in patients with somatic diagnoses, female patients scored significantly higher than male patients.
The symptoms of exhaustion measured with KEDS were higher in patients with stress-related diagnoses and major depression disorder than in patients with somatic diagnoses. The intermediate level of the symptoms of exhaustion that were associated with problems related to employment and unemployment, (Z56) compared to the lower level of the symptoms with somatic diagnoses, suggests that KEDS might be useful in detecting mild, prodromal states of exhaustion. This needs further investigation.
近年来，出现了几种评估与压力相关的疲惫症状的评分量表。然而，我们需要更多关于这些评分量表在与压力相关的障碍患者以及其他患者群体中的表现的知识。我们使用最近开发的卡罗林斯卡疲惫障碍量表（KEDS），根据诊断对不同的患者群体进行了比较，以评估其疲惫症状。
我们从丹麦三家医院的职业医学部门连续抽取患者。总研究组包括 698 名寻求治疗的患者（487 名女性）。与应激相关的诊断患者（n=217；国际疾病分类[ICD]-10 代码 F43：严重应激反应和适应障碍）与患有各种躯体诊断的患者（n=338）和患有其他精神科诊断的患者（n=143）进行了比较，包括患有重性抑郁症障碍亚组（n=34；F32 和 F33）和与就业和失业相关问题亚组（n=99；Z56）。数据分析使用 SPSS 统计程序进行线性混合模型。
应激相关诊断患者的 KEDS 总分平均值（29.3；SD=8.0）明显高于其他精神科诊断患者（25.9；SD=9.5）和躯体诊断患者（17.6；SD=10.8）。重性抑郁症障碍亚组的 KEDS 总分平均值较高（31.4，SD=8.1），与应激相关诊断患者相似，而与就业和失业相关问题患者（Z56）的 KEDS 总分平均值为 23.5（SD=9.0）。年轻和年老患者在 KEDS 上的评分相似，但在躯体诊断患者中，女性患者的评分明显高于男性患者。
使用 KEDS 测量的疲惫症状在应激相关诊断和重性抑郁症障碍患者中高于躯体诊断患者。与躯体诊断相关的与就业和失业相关问题的疲惫症状处于中等水平，（Z56）与躯体诊断相关的疲惫症状的较低水平相比，这表明 KEDS 可能有助于检测轻度、前驱状态的疲惫。这需要进一步研究。
