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多发性硬化症患者的抑郁、焦虑、疾病接受度和药物依从性水平 - 描述性和相关性研究。

The Levels of Depression, Anxiety, Acceptance of Illness, and Medication Adherence in Patients with Multiple Sclerosis - Descriptive and Correlational Study.

机构信息

Department of Nervous System Diseases, Wroclaw Medical University, Wroclaw, Poland.

出版信息

Int J Med Sci. 2021 Jan 1;18(1):216-225. doi: 10.7150/ijms.51172. eCollection 2021.

Abstract

Emotional functioning is one of the factors affecting medication adherence in patients with multiple sclerosis (MS). Adherence to treatment is a very important element in the therapy of patients with MS and requires from them cooperation, positive emotional status and acceptance of illness. This study evaluated the role of depression, anxiety, and the acceptance of illness on adherence to disease-modifying therapies (DMT) in MS. A group of 226 MS patients was included. The Beck Depression Inventory (BDI), the Hospital Anxiety and Depression Scale-Modified Version (HADS-M), the Acceptance of Illness Scale (AIS) and the Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ) were used. It was shown that 41% of patients reported the symptoms of anxiety, 28% reported the symptoms of depression, and 63% were irritated and aggressive (HADS-M). Over 80% of patients accept their disease to varying degrees. There was a correlation between the results of HADS-M, BDI, and AIS and the domains of MS-TAQ. Analysis of the multiple-regression model showed that only being very satisfied with treatment positively affects adherence to DMT in MS patients. It has to be concluded that anxiety and depression have a significant negative impact on medication adherence in MS patients. However, MS patients with an increased acceptance of their illness have a higher rate of adherence to DMT. The emotional state of a patient is an important factor that can both positively and negatively affect their adherence and their resulting prognosis.

摘要

情绪功能是影响多发性硬化症 (MS) 患者药物依从性的因素之一。对治疗的依从性是 MS 患者治疗的一个非常重要的因素,需要他们合作、保持积极的情绪状态并接受疾病。本研究评估了抑郁、焦虑和对疾病的接受程度对 MS 患者对疾病修正治疗 (DMT) 的依从性的影响。纳入了一组 226 名 MS 患者。使用贝克抑郁量表 (BDI)、医院焦虑和抑郁量表修订版 (HADS-M)、疾病接受量表 (AIS) 和多发性硬化症治疗依从性问卷 (MS-TAQ)。结果显示,41%的患者报告有焦虑症状,28%的患者报告有抑郁症状,63%的患者有烦躁和攻击性 (HADS-M)。超过 80%的患者在不同程度上接受了他们的疾病。HADS-M、BDI 和 AIS 的结果与 MS-TAQ 的各个领域之间存在相关性。多元回归模型分析表明,只有对治疗非常满意才会对 MS 患者 DMT 的依从性产生积极影响。结论是,焦虑和抑郁对 MS 患者的药物依从性有显著的负面影响。然而,对疾病接受程度较高的 MS 患者对 DMT 的依从性更高。患者的情绪状态是一个重要的因素,可以积极或消极地影响他们的依从性及其预后。

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