Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.
Braz J Psychiatry. 2020 Apr;42(2):190-194. doi: 10.1590/1516-4446-2018-0333. Epub 2019 Aug 5.
Parkinson's disease (PD) is often accompanied by stigma, which could contribute to a worse prognosis. The objective of this study is to identify the variables associated with stigma in PD patients who are candidates for deep brain stimulation (DBS).
We investigated sociodemographic and clinical variables associated with stigma in a sample of 54 PD patients indicated for DBS. The independent variables were motor symptoms assessed by the Movement Disorder Society-sponsored revision of the Unified Parkinson Disease Rating Scale (MDS-UPDRS III), depressive symptoms measured by the Hospital Anxiety and Depression Scale, age, disease duration and the presence of a general medical condition. The Mobility, Activities of daily living and Emotional well-being domains of the 39-item Parkinson's Disease Questionnaire (PDQ-39) were also investigated as independent variables, and the Stigma domain of the PDQ-39 scale was considered the outcome variable.
After multiple linear regression analysis, activities of daily living remained associated with the Stigma domain (B = 0.42 [95%CI 0.003-0.83], p = 0.048). The full model accounted for 15% of the variance in the Stigma domain (p = 0.03).
Although causal assumptions are not appropriate for cross-sectional studies, the results suggest that ADL difficulties could contribute to greater stigma in PD patients with refractory motor symptoms who are candidates for DBS.
帕金森病(PD)常伴有耻辱感,这可能导致预后更差。本研究的目的是确定与深部脑刺激(DBS)候选患者的 PD 患者耻辱感相关的变量。
我们调查了 54 名 PD 患者的社会人口统计学和临床变量与耻辱感的关系,这些患者被认为适合进行 DBS。自变量为运动障碍协会赞助的统一帕金森病评定量表(MDS-UPDRS III)评估的运动症状、医院焦虑和抑郁量表评估的抑郁症状、年龄、疾病持续时间和一般医疗状况。39 项帕金森病问卷(PDQ-39)的活动和日常生活以及情绪幸福感领域也被视为自变量,PDQ-39 量表的耻辱感领域被视为因变量。
经过多元线性回归分析,日常生活活动仍然与耻辱感领域相关(B=0.42[95%CI 0.003-0.83],p=0.048)。全模型解释了耻辱感领域 15%的方差(p=0.03)。
尽管对于横断面研究来说,因果假设是不合适的,但结果表明,对于难治性运动症状且适合进行 DBS 的 PD 患者,日常生活困难可能会导致更大的耻辱感。