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重症肌无力精神共病综述

A Review of Psychiatric Comorbidity in Myasthenia Gravis.

作者信息

Law Christina, Flaherty Claire V, Bandyopadhyay Sankar

机构信息

Medicine, Penn State College of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.

Neurology, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.

出版信息

Cureus. 2020 Jul 14;12(7):e9184. doi: 10.7759/cureus.9184.

Abstract

This study aimed to review studies focused on the affective comorbidities associated with myasthenia gravis and to determine the extent to which neuromuscular treatment modalities address non-somatic aspects of autoimmune myasthenia gravis. Depression, anxiety, and emotional hyperactivity can aggravate myasthenia gravis, hinder accurate diagnoses, and presumably influence overall health-related quality of life. Studies were identified using PubMed Medline and Web of Science to assess the effects of psychological factors on myasthenia gravis, encompassing 49 years of research worldwide. After analysis, approximately 6,060 patients from 32 studies worldwide between 1971 and 2020 were included. Standard-of-care approaches to diagnosis and treatment continue to under-appreciate the prevalence or impact of mood disorders in myasthenia gravis. The majority of studies evaluated demonstrated an association between myasthenia gravis and mood disorders. However, the initiative to detect and treat affective comorbidities probably remains suboptimal. Although treatments for the somatic effects of myasthenia gravis have evolved over the past century, the paradigm of clinical practice has yet to adequately address the management of psychological impacts on the disease. This review is hoped to raise the necessary awareness in this regard.

摘要

本研究旨在回顾聚焦于重症肌无力相关情感共病的研究,并确定神经肌肉治疗方式在多大程度上解决了自身免疫性重症肌无力的非躯体方面问题。抑郁、焦虑和情绪多动会加重重症肌无力,妨碍准确诊断,并可能影响整体健康相关生活质量。通过使用PubMed Medline和Web of Science检索相关研究,以评估心理因素对重症肌无力的影响,涵盖了全球49年的研究。经过分析,纳入了1971年至2020年间全球32项研究中的约6060名患者。诊断和治疗的标准护理方法仍然没有充分认识到情绪障碍在重症肌无力中的患病率或影响。大多数评估研究表明重症肌无力与情绪障碍之间存在关联。然而,检测和治疗情感共病的主动性可能仍然欠佳。尽管在过去一个世纪中,针对重症肌无力躯体影响的治疗有所发展,但临床实践模式尚未充分解决对该疾病心理影响的管理问题。希望本综述能在这方面提高必要的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6837/7425828/dee9b6872e75/cureus-0012-00000009184-i01.jpg

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