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日本 COVID-19 大流行期间帕金森病患者出现神经精神症状的风险因素。

Risk factors for neuropsychiatric symptoms in patients with Parkinson's disease during COVID-19 pandemic in Japan.

机构信息

Department of Molecular Pathobiology of Brain Diseases, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan.

出版信息

PLoS One. 2021 Jan 22;16(1):e0245864. doi: 10.1371/journal.pone.0245864. eCollection 2021.

Abstract

The worsening of neuropsychiatric symptoms such as depression, anxiety, and insomnia in patients with Parkinson's disease (PD) has been a concern during the COVID-19 pandemic, because most people worked in self-isolation for fear of infection. We aimed to clarify the impact of social restrictions imposed due to the COVID-19 pandemic on neuropsychiatric symptoms in PD patients and to identify risk factors associated with these symptoms. A cross-sectional, hospital-based survey was conducted from April 22, 2020 to May 15, 2020. PD patients and their family members were asked to complete paper-based questionnaires about neuropsychiatric symptoms by mail. PD patients were evaluated for motor symptoms using MDS-UPDRS part 2 by telephone interview. A total of 71 responders (39 PD patients and 32 controls) completed the study. Although there was no difference in the age distribution, the rate of females was significantly lower in PD patients (35%) than controls (84%) (P < 0.001). Participants with clinical depression (PHQ-9 score ≥ 10) were more common in PD patients (39%) than controls (6%) (P = 0.002). Multivariate logistic regression analysis revealed that an MDS-UPDRS part 2 score was correlated with the presence of clinical depression (PHQ-9 score ≥ 10) and clinical anxiety (GAD-7 score ≥ 7) (clinical depression: OR, 1.31; 95% CI, 1.04-1.66; P = 0.025; clinical anxiety: OR, 1.36; 95% CI, 1.07-1.72; P = 0.013). In the presence of social restrictions, more attention needs to be paid to the neuropsychiatric complications of PD patients, especially those with more severe motor symptoms.

摘要

在 COVID-19 大流行期间,帕金森病(PD)患者的神经精神症状(如抑郁、焦虑和失眠)恶化一直令人担忧,因为大多数人因担心感染而进行自我隔离。我们旨在阐明由于 COVID-19 大流行而实施的社会限制对 PD 患者神经精神症状的影响,并确定与这些症状相关的危险因素。 2020 年 4 月 22 日至 5 月 15 日进行了一项横断面、基于医院的调查。通过邮件向 PD 患者及其家属发送问卷,以了解他们的神经精神症状。通过电话访谈使用 MDS-UPDRS 第 2 部分评估 PD 患者的运动症状。共有 71 名应答者(39 名 PD 患者和 32 名对照者)完成了研究。尽管年龄分布无差异,但 PD 患者中女性的比例(35%)明显低于对照组(84%)(P<0.001)。 PD 患者中出现临床抑郁(PHQ-9 评分≥10)的比例(39%)明显高于对照组(6%)(P=0.002)。多变量逻辑回归分析显示,MDS-UPDRS 第 2 部分评分与临床抑郁(PHQ-9 评分≥10)和临床焦虑(GAD-7 评分≥7)的存在相关(临床抑郁:OR,1.31;95%CI,1.04-1.66;P=0.025;临床焦虑:OR,1.36;95%CI,1.07-1.72;P=0.013)。在存在社会限制的情况下,需要更加关注 PD 患者的神经精神并发症,尤其是那些运动症状更严重的患者。

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