Department of Psychology, NHO Chibahigashi National Hospital, Chiba, Japan.
Department of Psychiatry, NHO Shimofusa Psychiatric Medical Center, Chiba, Japan; Department of Psychiatry, NHO Chibahigashi National Hospital, Chiba, Japan.
J Psychosom Res. 2024 Dec;187:111915. doi: 10.1016/j.jpsychores.2024.111915. Epub 2024 Sep 3.
Although psychological distress is a prevalent issue among patients with amyotrophic lateral sclerosis (ALS) and can impact survival, the risk factors contributing to this distress remain insufficiently understood.
Patients with ALS who completed the Profile of Mood States (POMS) between June 2017 and March 2022 were included. Participants with moderate to severe cognitive decline were excluded, resulting in the recruitment of 121 patients. The associations between POMS profiles and clinical characteristics were analyzed. Physical motor symptoms were evaluated using the Revised ALS Functional Rating Scale (ALSFRS-R) for objective measurement and the 40-item ALS Assessment Questionnaire (ALSAQ-40) for subjective assessment.
Our model, employing the ALSFRS-R, revealed significant factors associated with overall psychological distress, as assessed by the POMS, including upper limb symptoms, the presence of sleep apnea syndrome, older age at onset, and male sex, with an inverse association with tracheostomy. The POMS subscale scores revealed that anger and depression were significantly associated with upper limb symptoms. The second model, which employed subjective scales, yielded similar results, reinforcing the robustness of our findings. Moreover, subjective bulbar symptoms on the ALSAQ-40 were significantly associated with psychological distress, particularly in female patients.
This study identified the main clinical characteristics significantly associated with psychological distress in patients with ALS. Our findings may be useful in developing individualized psychological management strategies for these patients.
尽管心理困扰是肌萎缩侧索硬化症（ALS）患者中普遍存在的问题，并且可能会影响生存，但导致这种困扰的风险因素仍了解不足。
我们纳入了在 2017 年 6 月至 2022 年 3 月期间完成了状态特质问卷（POMS）的 ALS 患者。排除了有中度至重度认知能力下降的参与者，最终共招募了 121 名患者。分析了 POMS 特征与临床特征之间的关系。使用修订后的 ALS 功能评定量表（ALSFRS-R）进行客观测量和 40 项 ALS 评估问卷（ALSAQ-40）进行主观评估来评估躯体运动症状。
我们的模型使用 ALSFRS-R，揭示了与 POMS 评估的整体心理困扰相关的显著因素，包括上肢症状、睡眠呼吸暂停综合征的存在、发病年龄较大以及男性，与气管造口术呈负相关。POMS 子量表评分显示，愤怒和抑郁与上肢症状显著相关。采用主观量表的第二个模型也得出了类似的结果，进一步证实了我们发现的稳健性。此外，ALSAQ-40 上的主观球部症状与心理困扰显著相关，尤其是女性患者。
本研究确定了与 ALS 患者心理困扰显著相关的主要临床特征。我们的发现可能有助于为这些患者制定个体化的心理管理策略。
