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肌营养不良症患儿和青年期患者家庭的心理健康和应对策略。

Mental health and coping strategies in families of children and young adults with muscular dystrophies.

机构信息

Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Via Don Luigi Monza 20, Bosisio Parini, Lecco, Italy.

Neuromuscular Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy.

出版信息

J Neurol. 2020 Jul;267(7):2054-2069. doi: 10.1007/s00415-020-09792-6. Epub 2020 Mar 28.

Abstract

BACKGROUND

Living with a progressive disease as muscular dystrophy (MD) can be challenging for the patient and the entire family from both emotional and practical point of view. We aimed to extend our previously published data about mental health in patients with MDs, also investigating coping profiles of both themselves and their parents. Furthermore, we wanted to verify whether psychological adaptation of patients can be predicted by coping strategies, taking also into account physical impairment, cognitive level and socioeconomic status.

METHODS

112 patients with MDs, aged 2-32 were included. Their emotional and behavioural features were assessed through parent- and self-report Achenbach System for Empirically Based Assessment questionnaires and Strength and Difficulties Questionnaires. Development and Well-Being Assessment or Autism Diagnostic Observation Schedule were administered to confirm suspected diagnoses. Coping profile of both parents and patients was assessed through the self-administered New Italian Version of the Coping Orientation to the Problems Experienced questionnaire and its relationship with emotional/behavioural outcome was examined in linear regression analyses.

RESULTS

High prevalence of intellectual disability and autism spectrum disorders was confirmed in Duchenne MD. Despite the high rate of internalizing symptomatology, we did not report higher rate of psychopathological disorders compared to general population. Parents tend to rely more on positive reinterpretation and less on disengagement coping. Avoidance coping, whether used by parents or patients, and ID, predicted increased emotional/behavioural problems.

CONCLUSIONS

Psychosocial interventions should address problems of anxiety and depression that people with MDs frequently experience, even through fostering parents' and childrens' engagement coping over disengagement coping.

摘要

背景

患有进行性疾病,如肌肉萎缩症(MD),无论是从情感还是实际角度来看,都会给患者和整个家庭带来挑战。我们旨在扩展我们之前发表的关于 MD 患者心理健康的数据,同时调查他们自己和父母的应对方式。此外,我们还想验证患者的心理适应是否可以通过应对策略来预测,同时考虑到身体损伤、认知水平和社会经济地位。

方法

纳入 112 名 MD 患者,年龄 2-32 岁。通过家长和自我报告的 Achenbach 系统经验评估问卷和强项和困难问卷评估他们的情绪和行为特征。发育和幸福感评估或自闭症诊断观察量表用于确认疑似诊断。通过自我管理的新意大利版应对体验问题取向问卷评估父母和患者的应对方式,并通过线性回归分析检查其与情绪/行为结果的关系。

结果

在杜兴肌营养不良症中证实了高比例的智力残疾和自闭症谱系障碍。尽管存在较高的内化症状发生率,但与一般人群相比,我们并未报告更高的精神病理障碍发生率。父母倾向于更多地依赖积极的重新解释,而较少依赖脱离应对。回避应对,无论是父母还是患者使用,以及 ID,都预示着情绪/行为问题的增加。

结论

心理社会干预措施应解决 MD 患者经常经历的焦虑和抑郁问题,即使是通过培养父母和孩子的参与应对方式而不是脱离应对方式。

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