Kane Alexa, Thompson Nicolas R, Sullivan Amy B
Mellen Center for Multiple Sclerosis (AK, ABS), Cleveland Clinic, Cleveland, OH, USA.
Department of Qualitative Health Sciences (NRT), Cleveland Clinic, Cleveland, OH, USA.
Int J MS Care. 2022 Mar-Apr;24(2):63-66. doi: 10.7224/1537-2073.2020-131. Epub 2021 Jun 10.
Depression is a common comorbidity in patients with multiple sclerosis (MS) and is associated with decreased quality of life. Identifying treatments that aid psychological and physical rehabilitation in patients with MS provides valuable information for interdisciplinary teams.
Seventy-five adults with MS who completed the Patient Health Questionnaire-9 (PHQ-9) and Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health scale during routine physical therapy appointments where the (CAREN) system was used were studied. Data were retrospective and collected via patient-reported outcomes. Group comparisons used 2-sample tests or Mann-Whitney tests for continuous variables and Fisher exact tests for categorical variables. To examine self-reported depression, mean ± SD baseline scores were computed and stratified by number of CAREN sessions.
Patients with 5 or more sessions seemed to have lower baseline PHQ-9 and PROMIS Mental Health scores; however, no significant differences were found at the univariate level. There were no statistically significant differences in follow-up scores for the outcome measures.
Current research evaluating the rehabilitation of patients with MS using the CAREN system is scarce. This pilot study is important to inform prospective studies exploring use of the CAREN system for psychological rehabilitation. Patients with 5 or more CAREN sessions had lower baseline PHQ-9 scores, which may suggest that mood plays a role in the selection of patients for CAREN system use. This study shows that mood is not affected by the CAREN system. More specific research needs to be completed with a more robust sample.
抑郁症是多发性硬化症（MS）患者常见的合并症，与生活质量下降有关。确定有助于MS患者心理和身体康复的治疗方法，可为多学科团队提供有价值的信息。
对75名成年MS患者进行了研究，这些患者在使用（CAREN）系统的常规物理治疗预约期间完成了患者健康问卷-9（PHQ-9）和患者报告结局测量信息系统（PROMIS）全球健康量表。数据为回顾性数据，通过患者报告结局收集。对于连续变量，组间比较使用双样本t检验或Mann-Whitney U检验；对于分类变量，使用Fisher精确检验。为了检查自我报告的抑郁症，计算了平均±标准差基线分数，并按CAREN疗程数进行分层。
接受5次或更多次疗程的患者似乎基线PHQ-9和PROMIS心理健康评分较低；然而，在单变量水平上未发现显著差异。结局指标的随访评分无统计学显著差异。
目前关于使用CAREN系统评估MS患者康复情况的研究较少。这项初步研究对于为探索将CAREN系统用于心理康复的前瞻性研究提供信息很重要。接受5次或更多次CAREN疗程的患者基线PHQ-9评分较低，这可能表明情绪在选择使用CAREN系统的患者中起作用。本研究表明情绪不受CAREN系统影响。需要用更具代表性的样本完成更具体的研究。
