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纤维肌痛症患儿和成年期注意缺陷多动障碍症状:与抑郁、焦虑和疾病影响的关系。

Childhood and adult attention deficit hyperactivity disorder symptoms in fibromyalgia: associations with depression, anxiety and disease impact.

机构信息

Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey.

Department of Algology, Istanbul University Medical Faculty, Istanbul, Turkey.

出版信息

Int J Psychiatry Clin Pract. 2020 Sep;24(3):257-263. doi: 10.1080/13651501.2020.1764585. Epub 2020 May 13.

Abstract

The first aim of this study was to determine the prevalence of childhood and current attention deficit hyperactivity disorder (ADHD) symptoms in patients with fibromyalgia. The second aim is to assess the role of depression and anxiety on the relationship between childhood and adult ADHD symptoms with disease impact in this population. Sixty-four patients with fibromyalgia were compared to matched 58 healthy controls. All participants completed the Wender Utah Rating Scale (WURS), Adult ADHD Self-Report Scale (ASRS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Fibromyalgia Impact Questionnaire (FIQ). Patients with fibromyalgia had significantly higher mean scores of depression (BDI), anxiety (BAI), childhood ADHD symptoms (WURS) and adult ADHD symptoms (ASRS total, ASRS hyperactivity/impulsivity subscale and ASRS attention deficit subscale) than the control group. Fibromyalgia impact (FIQ) was significantly correlated with depression (BDI;  = 0.57, < .001), anxiety (BAI;  = 0.56, < .001) and childhood ADHD symptoms (WURS;  = 0.41, < .001) in fibromyalgia group. There was no significant correlation between fibromyalgia impact (FIQ) and adult ADHD symptoms (ASRS total or sub-scale scores). Hierarchical multiple regression indicated that childhood ADHD symptoms (WURS), anxiety (BAI) and depression (BDI) predicted fibromyalgia impact. Both anxiety (BAI) and depression (BDI) mediated the relationship between childhood ADHD symptoms (WURS) and fibromyalgia impact (FIQ). Childhood ADHD symptoms may be a contributory factor to poorer functioning in the patients with fibromyalgia. The relationship was more pronounced in the presence of depression and anxiety symptoms. Evaluation of childhood and adult ADHD symptoms in patients with fibromyalgia is important for recognition and treatment of ADHD comorbidity and also for attenuating the severity of the disease.

摘要

这项研究的首要目的是确定纤维肌痛患者中儿童期和当前注意力缺陷多动障碍(ADHD)症状的患病率。第二个目的是评估抑郁和焦虑在儿童期和成年 ADHD 症状与该人群疾病影响之间的关系中的作用。将 64 名纤维肌痛患者与匹配的 58 名健康对照者进行比较。所有参与者均完成了 Wender Utah 评定量表(WURS)、成人 ADHD 自评量表(ASRS)、贝克抑郁量表(BDI)、贝克焦虑量表(BAI)和纤维肌痛影响问卷(FIQ)。纤维肌痛患者的抑郁(BDI)、焦虑(BAI)、儿童期 ADHD 症状(WURS)和成年 ADHD 症状(ASRS 总分、ASRS 多动/冲动分量表和 ASRS 注意力缺陷分量表)的平均得分明显高于对照组。纤维肌痛影响(FIQ)与抑郁(BDI;  = 0.57, <.001)、焦虑(BAI;  = 0.56, <.001)和儿童期 ADHD 症状(WURS;  = 0.41, <.001)在纤维肌痛组中显著相关。纤维肌痛影响(FIQ)与成年 ADHD 症状(ASRS 总分或分量表得分)之间无显著相关性。分层多元回归表明,儿童期 ADHD 症状(WURS)、焦虑(BAI)和抑郁(BDI)预测纤维肌痛影响。焦虑(BAI)和抑郁(BDI)均介导儿童期 ADHD 症状(WURS)与纤维肌痛影响(FIQ)之间的关系。儿童期 ADHD 症状可能是纤维肌痛患者功能下降的一个促成因素。在存在抑郁和焦虑症状的情况下,这种关系更为明显。评估纤维肌痛患者的儿童期和成年 ADHD 症状对于识别和治疗 ADHD 共病以及减轻疾病的严重程度非常重要。

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