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多发性硬化症患者疼痛的患病率及其与焦虑、抑郁症状和生活质量的关联。

Prevalence of pain in patients with multiple sclerosis and its association with anxiety, depressive symptoms and quality of life.

作者信息

Łabuz-Roszak Beata, Niewiadomska Ewa, Kubicka-Bączyk Katarzyna, Skrzypek Michał, Tyrpień-Golder Krystyna, Majewska Anna, Matejczyk Anna, Dobrakowski Paweł, Pierzchała Krystyna

机构信息

Śląski Uniwersytet Medyczny w Katowicach, Wydział Zdrowia Publicznego w Bytomiu, Katedra i Zakład Podstawowych Nauk Medycznych.

Śląski Uniwersytet Medyczny w Katowicach, Wydział Zdrowia Publicznego w Bytomiu, Zakład Biostatystyki.

出版信息

Psychiatr Pol. 2019 Apr 30;53(2):475-486. doi: 10.12740/PP/94469.

Abstract

OBJECTIVES

Pain is one of the most frequently reported symptoms of multiple sclerosis (MS). It affects the daily functioning of patients, limits the ability to work and reduces the joy of life. The aim of the study was to analyze the impact of pain on quality of life as well as symptoms of anxiety and depression in patients with MS.

METHODS

The study included 144 patients with diagnosed MS (mean age 41±12 years, mean illness duration 10.3±8.6 years). The study was carried out on the basis of the author's survey on current and previous pain - the Quality of Life Self-esteem Questionnaire (EuroQol5D) and the Hospital Anxiety and Depression Scale (HADS).

RESULTS

Among all respondents, 117 (81.3%) reported current pain, and 120 (83.3%) declared the occurrence of pain in the past. Currently, patients have reported: pain in one or more extremities - 79 people (54.9%), headache and facial pain - 72 (50%), back pain - 72 (50%), painful muscle spasms - 54 (38.6%), ocular pain - 37 (25.7%), Lhermitte's sign - 32 (22.2%). Patients reporting pain experienced significantly more severe symptoms of anxiety and depression (HADS-L: 8.0±4.3 vs. 5.1±4.3; p< 0.01; HADS-D: 6.0±4.2 vs. 3.4±3.7; p< 0.01), and had significantly worse quality of life (EQ 5D: 8.1±1.9 vs. 6.3±1.4; p< 0.0001). An association between presence of pain and gender (p< 0.01), age (p< 0.05), the degree of disability (p< 0.05), education (p< 0.001), and the professional activity (p< 0.01) was found.

CONCLUSIONS

Pain in MS is associated with more severe symptoms of anxiety and depression, and worse quality of life. Female sex, older age, lower level of education, greater disability, and lack of occupational work predispose to the occurrence of pain in MS.

摘要

目的

疼痛是多发性硬化症(MS)最常报告的症状之一。它影响患者的日常功能,限制工作能力并降低生活乐趣。本研究的目的是分析疼痛对MS患者生活质量以及焦虑和抑郁症状的影响。

方法

该研究纳入了144例确诊为MS的患者(平均年龄41±12岁,平均病程10.3±8.6年)。该研究是基于作者对当前和既往疼痛情况的调查开展的,采用了生活质量自尊问卷(EuroQol5D)和医院焦虑抑郁量表(HADS)。

结果

在所有受访者中,117人(81.3%)报告当前有疼痛,120人(83.3%)宣称过去曾发生过疼痛。目前,患者报告的疼痛情况如下:一个或多个肢体疼痛——79人(54.9%),头痛和面部疼痛——72人(50%),背痛——72人(50%),肌肉疼痛性痉挛——54人(38.6%),眼部疼痛——37人(25.7%),莱尔米特征——32人(22.2%)。报告有疼痛的患者经历的焦虑和抑郁症状明显更严重(HADS-L:8.0±4.3对5.1±4.3;p<0.01;HADS-D:6.0±4.2对3.4±3.7;p<0.01),生活质量也明显更差(EQ 5D:8.1±1.9对6.3±1.4;p<0.0001)。发现疼痛的存在与性别(p<0.01)、年龄(p<0.05)、残疾程度(p<0.05)、教育程度(p<0.001)和职业活动(p<0.01)之间存在关联。

结论

MS中的疼痛与更严重的焦虑和抑郁症状以及更差的生活质量相关。女性、年龄较大、教育水平较低、残疾程度较高以及没有职业工作更容易导致MS患者出现疼痛。

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