使用《精神疾病诊断与统计手册》第五版人格障碍结构化临床访谈对系统性红斑狼疮患者的人格障碍、生活质量和疾病活动度进行评估。
Evaluation of personality disorders using the structured clinical interview for DSM-5 personality disorders, quality of life, and disease activity in patients with systemic lupus erythematosus.
作者信息
Durmaz Yunus, İlhanlı İlker, Durmaz Pınar
机构信息
Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Karabük Training and Research Hospital, Karabük, Türkiye.
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Türkiye.
出版信息
Arch Rheumatol. 2022 Sep 6;37(3):326-334. doi: 10.46497/ArchRheumatol.2022.9002. eCollection 2022 Sep.
OBJECTIVES
This study aims to determine the frequency of personality disorders in patients with systemic lupus erythematosus (SLE) and healthy volunteers and to compare SLE patients with and without personality disorders in terms of quality of life (QoL) and other clinical and laboratory findings.
PATIENTS AND METHODS
Between January 2021 and March 2021, a total of 64 patients (17 males, 47 females; mean age: 42.9±10.8 years; range, 21 to 62 years) who were diagnosed with SLE and 68 age- and sex-matched healthy volunteers (20 males, 48 females; mean age: 40.9±10.6 years; range, 21 to 65 years) without any known disease were included. The Nottingham Health Profile (NHP) was filled in to evaluate the QoL for all participants. For the diagnosis of personality disorder, the Structured Clinical Interview For DSM-5 Personality Disorders (SCID-5PD) form was used. Clinical and laboratory findings of patients with SLE were noted and disease activity index (SLEDAI) was calculated. Clinical and laboratory variables that may affect personality disorder were evaluated.
RESULTS
The prevalence of personality disorder in SLE patients was significantly higher than the control group (39.1% vs. 11.8%, respectively; p<0.001). In terms of the subgroups of personality disorders detected in SLE, only the prevalence of obsessive-compulsive personality disorder was significantly higher than the control group (26.6% vs. 10.3%, respectively; p=0.015). The frequency of personality disorder increased, as the education level decreased, the duration of SLE disease increased, and with antiphospholipid autoantibodies positivity in patients with SLE (p<0.05). The mean NHP total score was 126.1±55.1 in SLE patients with personality disorder and 62.9±43.8 in patients without personality disorder, indicating that the QoL of SLE patients with personality disorder was worse than those without personality disorder (p<0.001).
CONCLUSION
The frequency of personality disorder in SLE seems to be higher than in the control group. Quality of life is adversely affected in SLE patients with personality disorders. Therefore, clinicians should be alert for personality disorders that may accompany SLE and fight with personality disorder with early diagnosis and optimal treatment.
目的
本研究旨在确定系统性红斑狼疮（SLE）患者和健康志愿者中人格障碍的发生率，并比较有无人格障碍的SLE患者在生活质量（QoL）以及其他临床和实验室检查结果方面的差异。
患者与方法
纳入2021年1月至2021年3月期间共64例确诊为SLE的患者（17例男性，47例女性；平均年龄：42.9±10.8岁；范围21至62岁）以及68例年龄和性别匹配的无任何已知疾病的健康志愿者（20例男性，48例女性；平均年龄：40.9±10.6岁；范围21至65岁）。所有参与者均填写诺丁汉健康量表（NHP）以评估生活质量。采用《精神障碍诊断与统计手册》第5版人格障碍结构化临床访谈表（SCID-5PD）进行人格障碍的诊断。记录SLE患者的临床和实验室检查结果并计算疾病活动指数（SLEDAI）。评估可能影响人格障碍的临床和实验室变量。
结果
SLE患者中人格障碍的患病率显著高于对照组（分别为39.1%和11.8%；p<0.001）。在SLE中检测到的人格障碍亚组方面,仅强迫型人格障碍的患病率显著高于对照组（分别为26.6%和10.3%；p=0.015）。随着SLE患者教育水平降低、疾病持续时间增加以及抗磷脂自身抗体呈阳性，人格障碍的发生率升高（p<0.05）。有人格障碍的SLE患者NHP总分平均为126.1±55.1，无人格障碍的患者为62.9±43.8，表明有人格障碍的SLE患者生活质量比无人格障碍的患者更差（p<0.001）。
结论
SLE患者中人格障碍的发生率似乎高于对照组。有人格障碍的SLE患者生活质量受到不利影响。因此，临床医生应警惕SLE可能伴发的人格障碍，并通过早期诊断和最佳治疗来应对人格障碍。
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