Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
Institute of Psychology, Westfälische Wilhelms-Universität Münster, Münster, Germany.
Psychoneuroendocrinology. 2020 Mar;113:104548. doi: 10.1016/j.psyneuen.2019.104548. Epub 2019 Dec 23.
Turner syndrome (TS) affects approximately one out of 2500 females. Previous research indicates that women with TS experience impairment in several psychosocial domains as well as in quality of life (QoL). Data, however, mainly focus on girls, whereas data on adult women is extremely scarce, inconsistent and mainly low in sample size. Separate analysis of adult women, however, is important since women face other challenges of TS than girls.
We compared 301 women with TS aged 16-73 years (from 14 centres in six European countries) to healthy controls with regard to depression, anxiety, self-esteem, attention deficit/hyperactivity disorder (ADHD), autism, romantic relationships, social participation, amount of working hours and satisfaction with income as well as with regard to psychological, physical, environmental, social and global QoL. The influence of psychosocial well-being on the different QoL-domains was examined via multiple regression models.
Women with TS showed impairments in all psychosocial variables (anxiety, depression, ADHD, autism, self-esteem, social participation all p < 0.001) except for the amount of working hours (p = 0.062) and satisfaction with income (p = 0.369). They also showed lower social (p < 0.001), psychological (p < 0.001) and physical QoL (p < 0.001) compared to controls. Depression, satisfaction with income and self-esteem could be shown to be the best predictors for QoL.
In conclusion, quality of life in TS is impaired, in particular it seems to be negatively affected by depression and low self-esteem whereas satisfaction with income has a positive influence. These results implicate that medical staff needs to pay attention on possible psychosocial impairments when treating women with TS. Strengthening self-esteem and counteracting depression potentially raises their QoL.
特纳综合征(TS)影响大约每 2500 名女性中的 1 名。先前的研究表明,患有 TS 的女性在多个社会心理领域以及生活质量(QoL)方面存在障碍。然而,数据主要集中在女孩身上,而关于成年女性的数据极其稀缺、不一致,且主要样本量较小。然而,对成年女性进行单独分析很重要,因为女性面临的 TS 挑战与女孩不同。
我们比较了来自六个欧洲国家 14 个中心的 301 名 16-73 岁的 TS 女性(TS 组)与健康对照组,比较了抑郁、焦虑、自尊、注意力缺陷/多动障碍(ADHD)、自闭症、恋爱关系、社会参与、工作时间和收入满意度,以及心理、身体、环境、社会和全球生活质量。通过多元回归模型检查了社会心理福祉对不同生活质量领域的影响。
TS 女性在所有社会心理变量(焦虑、抑郁、ADHD、自闭症、自尊、社会参与,所有 p<0.001)方面均存在障碍,除工作时间(p=0.062)和收入满意度(p=0.369)外。与对照组相比,她们的社会(p<0.001)、心理(p<0.001)和身体生活质量(p<0.001)也较低。抑郁、收入满意度和自尊可以被证明是生活质量的最佳预测因素。
总之,TS 患者的生活质量受损,特别是抑郁和低自尊似乎对其生活质量产生负面影响,而收入满意度则有积极影响。这些结果表明,医务人员在治疗 TS 女性时需要注意可能存在的社会心理障碍。增强自尊和对抗抑郁可能会提高她们的生活质量。