Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-752 Katowice, Poland.
Chair and Clinical Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-752 Katowice, Poland.
Medicina (Kaunas). 2024 Feb 23;60(3):376. doi: 10.3390/medicina60030376.
: The aim of this study was to determine the prevalence of mental disorders in a group of patients with multiple sclerosis (MS) during outpatient treatment. Additionally, an attempt was made to assess the influence of parameters related to patients and their clinical status on the prevalence of mental disorders. : This study was conducted between 2017 and 2018 in a group of 103 patients with MS who underwent treatment at the Outpatient Clinic of Neurology at the Clinical Hospital No. 1 in Zabrze, Poland. Sociodemographic data were collected, and the course of the underlying disease and comorbidities underwent assessment. The Mini International Neuropsychiatric Interview (MINI) and psychiatric examination were used to assess the occurrence of mental disorders. : In this study, female subjects accounted for 67.96% of patients (mean age: 43 years). Of all patients, 67% of subjects were clinically diagnosed with mental disorders during their lifetime. The results of the MINI Questionnaire showed that 33% of MS patients had a history of a major depressive episode, while 8.7% of patients met the criteria for a depressive episode. The same number of patients were treated for recurrent depressive disorders. Generalized anxiety disorder was diagnosed in 10.7% of patients, agoraphobia in 8.7% and panic disorder in 7.8%. Most patients (94.2%) had a low risk of suicide, according to the MINI Questionnaire. This study did not show a significant influence of age, sex, duration of MS symptoms or severity of symptoms as expressed by the Expanded Disability Status Score (EDSS) on the prevalence of mental disorders ( = 0.05). However, a significantly higher median EDSS score was found in patients with a history of mental disorders ( = 0.03). Additionally, a significant negative correlation was found between having a family and a psychiatric diagnosis ( = 0.01). A statistically significant negative correlation was found between the level of education and the suicide risk as assessed by the MINI Questionnaire ( = 0.03). : This study showed a high prevalence of mental disorders in patients with MS, of which depressive episodes and anxiety disorders were the most commonly reported. There may exist a relationship between the degree of disability of MS patients and a higher prevalence of mental disorders. Patients with MS who do not have a family may be more susceptible to mental disorders. In turn, patients with a lower level of education may show a higher risk of suicide. This suggests the need for psychological and psychiatric support for patients with MS, with particular consideration given to those who are alone, those with more severe disability and patients with a lower level of education.
本研究旨在确定一组多发性硬化症(MS)门诊治疗患者的精神障碍患病率。此外,还试图评估与患者及其临床状况相关的参数对精神障碍患病率的影响。
这项研究于 2017 年至 2018 年在波兰扎布热第一临床医院神经病学门诊接受治疗的 103 名 MS 患者中进行。收集了社会人口统计学数据,并评估了潜在疾病的病程和合并症。使用迷你国际神经精神访谈(MINI)和精神检查来评估精神障碍的发生情况。
在这项研究中,女性患者占 67.96%(平均年龄:43 岁)。在所有患者中,67%的患者在其一生中被临床诊断为精神障碍。MINI 问卷的结果显示,33%的 MS 患者有重度抑郁发作史,8.7%的患者符合抑郁发作标准。同样数量的患者接受了复发性抑郁障碍的治疗。10.7%的患者被诊断为广泛性焦虑症,8.7%的患者被诊断为广场恐惧症,7.8%的患者被诊断为惊恐障碍。根据 MINI 问卷,大多数患者(94.2%)自杀风险低。本研究未显示年龄、性别、MS 症状持续时间或扩展残疾状况评分(EDSS)表示的症状严重程度对精神障碍患病率有显著影响(=0.05)。然而,在有精神障碍病史的患者中发现了显著更高的中位数 EDSS 评分(=0.03)。此外,还发现家庭状况与精神科诊断之间存在显著负相关(=0.01)。MINI 问卷评估的自杀风险与教育程度之间存在显著负相关(=0.03)。
本研究表明,多发性硬化症患者的精神障碍患病率较高,其中抑郁发作和焦虑障碍最为常见。MS 患者的残疾程度与精神障碍患病率较高之间可能存在关系。没有家庭的 MS 患者可能更容易患精神障碍。相反,教育程度较低的患者自杀风险可能更高。这表明需要为多发性硬化症患者提供心理和精神支持,特别要考虑那些孤独、残疾更严重和教育程度较低的患者。