Grochowalska Kinga, Ziętkiewicz Marcin, Nowicka-Sauer Katarzyna, Topolski Mariusz, Więsik-Szewczyk Ewa, Matyja-Bednarczyk Aleksandra, Napiórkowska-Baran Katarzyna, Zdrojewski Zbigniew
Department of Rheumatology, Clinical Immunology, Geriatrics and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.
Department of Family Medicine, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.
Front Psychiatry. 2024 Mar 7;15:1293935. doi: 10.3389/fpsyt.2024.1293935. eCollection 2024.
Patients with inborn errors of immunity (IEI) experience recurrent infections, autoimmunity, and malignancies. Owing to repeated medical procedures, the need for constant treatment and surveillance, and the unpredictable course of the disease, patients with IEI are prone to develop mental health disorders, including anxiety. In this study, we aimed to assess the prevalence and level of anxiety symptoms in adult Polish patients with IEI and explore the determinants of anxiety in this group of patients.
Data from 105 Polish patients with IEI were collected via the hospital anxiety and depression scale (HADS), brief illness perception questionnaire (B-IPQ), illness cognition questionnaire (ICQ), Pittsburgh sleep quality index (PSQI), and a questionnaire on general health and demographic data. For statistical analyses of data, the normality of distribution of quantitative data was assessed, and internal consistency of tests was investigated using Cronbach's alpha coefficient; moreover, we performed the analysis of correlations and between-group differences, and path analysis to explore causal relationships. Significance was considered at < 0.050.
Thirty-eight (36.2%) patients had anxiety symptoms (HADS-A ≥ 8); 14 (13.3%) patients had severe anxiety (score ≥ 11), and 24 (22.9%) had moderate anxiety (score of 8-10). Patients with poor sleep quality, higher pain frequency, younger age, and no fixed income had higher anxiety scores than others. Emotional and cognitive representations of illness were positively correlated with anxiety levels. Intense anxiety was related to more negative illness perception, higher helplessness, lower illness acceptance, and lower perceived benefits.
Anxiety is common in patients with IEI. However, results indicate that it is not related to a more severe course of IEI or several comorbidities, whereas, pain frequency and poor sleep quality were identified to be important clinical factors for anxiety. Because anxiety was related to negative illness perception, psychological therapy may apply to this group of patients.
免疫缺陷病（IEI）患者会经历反复感染、自身免疫和恶性肿瘤。由于反复进行医疗程序、持续治疗和监测的需要以及疾病进程的不可预测性，IEI患者容易出现心理健康障碍，包括焦虑。在本研究中，我们旨在评估成年波兰IEI患者焦虑症状的患病率和程度，并探索该组患者焦虑的决定因素。
通过医院焦虑抑郁量表（HADS）、简短疾病认知问卷（B-IPQ）、疾病认知问卷（ICQ）、匹兹堡睡眠质量指数（PSQI）以及一份关于一般健康和人口统计学数据的问卷，收集了105名波兰IEI患者的数据。对于数据的统计分析，评估了定量数据分布的正态性，并使用Cronbach'sα系数研究了测试的内部一致性；此外，我们进行了相关性分析和组间差异分析，并进行路径分析以探索因果关系。显著性水平设定为<0.050。
38名（36.2%）患者有焦虑症状（HADS-A≥8）；14名（13.3%）患者有严重焦虑（评分≥11），24名（22.9%）有中度焦虑（评分8-10）。睡眠质量差、疼痛频率较高、年龄较小且无固定收入的患者焦虑得分高于其他人。疾病的情感和认知表征与焦虑水平呈正相关。强烈焦虑与更消极的疾病认知、更高的无助感、更低的疾病接受度和更低的感知益处有关。
焦虑在IEI患者中很常见。然而，结果表明它与IEI更严重的病程或几种合并症无关，而疼痛频率和睡眠质量差被确定为焦虑的重要临床因素。由于焦虑与消极的疾病认知有关，心理治疗可能适用于这组患者。
