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多发性硬化症(MS)中的焦虑和抑郁:先兆、后果以及对幸福感和生活质量的不同影响。

Anxiety and depression in Multiple Sclerosis (MS): Antecedents, consequences, and differential impact on well-being and quality of life.

作者信息

Hanna Mariam, Strober Lauren Beth

机构信息

Montclair State University, USA.

Kessler Foundation, West Orange, NJ, USA; Rutgers, the State University of New Jersey, New Jersey Medical School, Department of Physical Medicine and Rehabilitation, USA.

出版信息

Mult Scler Relat Disord. 2020 Sep;44:102261. doi: 10.1016/j.msard.2020.102261. Epub 2020 Jun 6.

Abstract

BACKGROUND

Individuals with multiple sclerosis (MS) are often plagued by the unpredictability of their disease and have to contend with uncertainty in their life and significant life changes. This can lead to high levels of stress, perceived lack of control, helplessness, and anxiety. Despite these circumstances, anxiety disorders are often overshadowed by depression, which can result in its presence being overlooked and undertreated by many medical professionals.

METHODS

One hundred and eighty three individuals with MS completed a comprehensive online survey assessing depression and anxiety and the demographic and disease risk factors of such, including social support and substance use. Participants also completed measures of MS symptomatology, disease management, psychological well-being, and quality of life to determine the impact of depression and anxiety on outcomes associated with MS.

RESULTS

Findings suggest that both depression and anxiety are prevalent in MS and related to many outcomes. However, based on comparisons of the associations and group comparisons, with a few exceptions, anxiety proved to more impactful than depression when examining these outcomes. When evaluating the risk factors/contributors of anxiety and depression, social support was a consistent predictor. Younger age and shorter disease duration were also associated with anxiety, while lower education and substance use were predictors of depression.

CONCLUSION

Findings suggest that attention to anxiety be given as much as depression as it plays a large role in individuals' perceived health and well-being, which subsequently impacts the severity of symptoms and overall quality of life. Early identification of anxiety and potential substance use and increased social support also appear to be crucial for mitigating the impact of depression and anxiety.

摘要

背景

多发性硬化症(MS)患者常常饱受疾病不可预测性的困扰,不得不应对生活中的不确定性和重大生活变化。这可能导致高度的压力、感觉缺乏控制感、无助感和焦虑。尽管存在这些情况,但焦虑症往往被抑郁症所掩盖,这可能导致许多医学专业人员忽视其存在并治疗不足。

方法

183名MS患者完成了一项全面的在线调查,评估抑郁和焦虑以及相关的人口统计学和疾病风险因素,包括社会支持和物质使用情况。参与者还完成了MS症状学、疾病管理、心理健康和生活质量的测量,以确定抑郁和焦虑对与MS相关结果的影响。

结果

研究结果表明,抑郁和焦虑在MS患者中都很普遍,且与许多结果相关。然而,基于关联比较和组间比较,除了少数例外,在检查这些结果时,焦虑比抑郁的影响更大。在评估焦虑和抑郁的风险因素/促成因素时,社会支持是一个一致的预测因素。年龄较小和病程较短也与焦虑有关,而教育程度较低和物质使用是抑郁的预测因素。

结论

研究结果表明,应给予焦虑与抑郁同样多的关注,因为焦虑在个体的感知健康和幸福感中起着很大作用,进而影响症状的严重程度和总体生活质量。早期识别焦虑和潜在的物质使用情况以及增加社会支持对于减轻抑郁和焦虑的影响似乎也至关重要。

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