前瞻性研究重症肌无力复发中的应激、抑郁和人格。
Prospective study of stress, depression and personality in myasthenia gravis relapses.
机构信息
Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Division of Neurology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto, 5EC, Room 309 200 Elizabeth St, Toronto, ON, M5G 2G4, Canada.
Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
出版信息
BMC Neurol. 2020 Jun 29;20(1):261. doi: 10.1186/s12883-020-01802-4.
BACKGROUND
Psychopathology and personality traits may influence the course of autoimmune disorders. With this prospective longitudinal cohort study, we aimed to assess personality, stress and depression in myasthenia patients who relapse and those who remain stable or improve (non-relapsers).
METHOD
We collected data from 155 consecutive adult patients with confirmed MG attending the Neuromuscular Clinic, Toronto General Hospital, between March 2017 and July 2018, for this study. Patients were assessed at baseline and 6 months, or at the time of MG relapse. At both visits, the patients were assessed clinically and were asked to complete self-administered questionnaires for disease severity, chronic stress and depression. Personality type was assessed at baseline only. Relapsing patients were defined as those patients with MGII score increasing by more than 5.5 points from visit 1 to visit 2.
RESULTS
Relapsers had higher baseline scores for depression (p = 0.01) and the change in disease severity correlated with the change in depression score (r = 0.2534, p = 0.0015, 95% CI: 0.098 0.3961). Higher levels of stress at baseline and neuroticism predicted higher relapse rates (p = 0.01 and p < .0001, respectively). In the linear regression model, with change of the MGII score as the dependent variable, change in depression scores (p = 0.0004) and age (p = 0.03) predicted change in disease severity.
CONCLUSIONS
Since emotional factors and personality type may influence MG, attention to these factors might improve care in MG patients.
背景
精神病理学和人格特质可能会影响自身免疫性疾病的病程。本前瞻性纵向队列研究旨在评估在复发和病情稳定或改善（非复发）的重症肌无力（MG）患者中，人格、压力和抑郁情况。
方法
本研究纳入了 2017 年 3 月至 2018 年 7 月期间在多伦多总医院神经肌肉诊所就诊的 155 例连续确诊的成年 MG 患者。在基线和 6 个月时，或在 MG 复发时收集患者的数据。在两次就诊时，对患者进行临床评估，并让他们完成自我管理的疾病严重程度、慢性压力和抑郁问卷。仅在基线评估人格类型。复发患者被定义为 MGII 评分从就诊 1 到就诊 2 增加超过 5.5 分的患者。
结果
复发患者的基线抑郁评分较高（p=0.01），疾病严重程度的变化与抑郁评分的变化相关（r=0.2534，p=0.0015，95%置信区间：0.098-0.3961）。基线时压力水平较高和神经质预测复发率较高（p=0.01 和 p<0.0001，分别）。在线性回归模型中，以 MGII 评分变化为因变量，抑郁评分变化（p=0.0004）和年龄（p=0.03）预测疾病严重程度的变化。
结论
由于情绪因素和人格类型可能影响 MG，因此关注这些因素可能会改善 MG 患者的护理。
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