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多发性硬化症患者的生活质量和抑郁症状:美国和西班牙的横断面研究。

Quality of Life and Depressive Symptomatology in Multiple Sclerosis: A Cross-Sectional Study Between the USA and Spain.

机构信息

Servicio de Psiquiatría, Psicología Clínica y Salud Mental del Hospital Universitario La Paz.

出版信息

Psicothema. 2021 Feb;33(1):60-69. doi: 10.7334/psicothema2020.151.

Abstract

BACKGROUND

For multinational clinical trials in multiple sclerosis (MS), identifying cross-country differences on quality of life (QoL) is important for understanding patients' response variability. No study has compared QoL between Spanish and American MS samples. This study aims to: 1) compare QoL and depressive symptomatology between Spanish and American patients, and against normative data; 2) compare the interrelationship between such constructs between countries; and 3) compare sociodemographic and clinical predictors on these outcomes.

METHOD

114 participants with MS were included and matched for gender, disability and education. The SF-36 Health Survey and BDI-FastScreen (BDI-FS) were the outcomes. ANCOVA, partial-correlations and multiple regression analyses were compared between countries.

RESULTS

Spaniards reported worse depressive symptomatology and QoL, and clinically significant impairment in all QoL dimensions, while Americans showed clinically significant impairment only in physical domains. Among Spaniards, more Bodily pain was more related to worse Social functioning and Vitality, and worse Vitality was more related to worse Social functioning than among Americans. From the regression models, Physical functioning predicted BDI-FS greater among Americans. Conversely, disability and Role-emotional predicted BDI-FS and Mental health, respectively, significantly stronger in Spain.

CONCLUSIONS

Spaniards show worse QoL and depressive symptomatology and greater clinically significant impairment than the Americans.

摘要

背景

对于多发性硬化症(MS)的跨国临床试验,了解生活质量(QoL)方面的跨国差异对于理解患者的反应变异性很重要。尚无研究比较过西班牙和美国 MS 样本之间的 QoL。本研究旨在:1)比较西班牙和美国患者的 QoL 和抑郁症状,以及与正常数据的比较;2)比较两国之间这些结构之间的相互关系;3)比较这些结果的社会人口统计学和临床预测因素。

方法

纳入了 114 名 MS 患者,并根据性别、残疾和教育程度进行了匹配。SF-36 健康调查和 BDI-FastScreen(BDI-FS)是评估结果。在两国之间比较了 ANCOVA、偏相关和多元回归分析。

结果

西班牙患者报告的抑郁症状和 QoL 更差,所有 QoL 维度均存在临床显著障碍,而美国患者仅在身体领域表现出临床显著障碍。在西班牙患者中,更多的身体疼痛与更差的社会功能和活力有关,而活力越差与社会功能越差的关系越密切,这与美国患者不同。从回归模型来看,美国患者的身体功能对 BDI-FS 的预测作用更大。相反,残疾和角色情感分别在西班牙对 BDI-FS 和心理健康的预测作用更强。

结论

与美国人相比,西班牙人表现出更差的 QoL 和抑郁症状,以及更大的临床显著障碍。

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