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在新冠疫情期间,创伤负担影响了多发性硬化症患者。

Trauma Burden Affected People with Multiple Sclerosis During SARS-CoV-2 Pandemic.

作者信息

Heidler Felicita, Hecker Michael, Frahm Niklas, Baldt Julia, Streckenbach Barbara, Meißner Janina, Burian Katja, Langhorst Silvan Elias, Mashhadiakbar Pegah, Richter Jörg, Zettl Uwe Klaus

机构信息

Department of Neurology, Ecumenic Hainich Hospital gGmbH, 99974 Mühlhausen, Germany.

Neuroimmunology Section, Department of Neurology, Rostock University Medical Center, 18147 Rostock, Germany.

出版信息

J Clin Med. 2025 Apr 13;14(8):2665. doi: 10.3390/jcm14082665.

Abstract

Trauma is a psychological injury resulting from a distressing or overwhelming event. The SARS-CoV-2 pandemic has been disruptive and traumatic for many people with multiple sclerosis (pwMS). The relationship between patient characteristics and trauma in pwMS during the pandemic has not yet been thoroughly explored. The aim of this bicentric prospective cohort study was to analyze the prevalence and development of probable post-traumatic stress disorder (PTSD) among pwMS during the SARS-CoV-2 pandemic and to identify patient parameters associated with this condition. We have assessed pwMS for probable PTSD before and after the approval of the first SARS-CoV-2 vaccines in Germany using an adapted version of the Trauma Screening Questionnaire (TSQ). We compared pwMS with probable PTSD (TSQ sum score ≥ 6) with those without probable PTSD (TSQ sum score < 6) regarding sociodemographic and MS-specific clinical characteristics, polypharmacy status, comorbidities, anxiety/depression levels, personality traits, mental/physical/social burden, and general vaccination willingness. Out of the 149 pwMS included, 8.1% were identified as having probable PTSD. These patients had significantly higher rates of pre-pandemic abnormal anxiety (66.7% vs. 18.5%, < 0.001) and depression scores (45.5% vs. 12.6%, = 0.013). The patients with probable PTSD exhibited a distinct personality profile, with significantly higher neuroticism and harm avoidance scores and lower conscientiousness, cooperativeness, and self-directedness scores. They were also significantly more likely to report severe or very severe mental/physical/social burdens during the pandemic compared to those without probable PTSD ( ≤ 0.045). Medical and social services should be provided to support patients who experienced serious stress or trauma. The development of concepts for education and vaccination procedures should be accompanied by comprehensive and clear communication that recognizes individual risk factors and addresses possible concerns with evidence-based and convincing arguments.

摘要

创伤是由令人痛苦或难以承受的事件导致的心理损伤。严重急性呼吸综合征冠状病毒2(SARS-CoV-2)大流行对许多多发性硬化症患者(pwMS)来说具有破坏性和创伤性。大流行期间,pwMS患者的特征与创伤之间的关系尚未得到充分探讨。这项双中心前瞻性队列研究的目的是分析SARS-CoV-2大流行期间pwMS中可能的创伤后应激障碍(PTSD)的患病率和发展情况,并确定与该疾病相关的患者参数。我们使用改编版的创伤筛查问卷(TSQ)在德国首次批准SARS-CoV-2疫苗之前和之后对pwMS患者进行了可能的PTSD评估。我们比较了可能患有PTSD(TSQ总分≥6)的pwMS患者和未患有可能PTSD(TSQ总分<6)的患者在社会人口统计学和MS特异性临床特征、联合用药情况、合并症、焦虑/抑郁水平、人格特质、心理/身体/社会负担以及一般疫苗接种意愿等方面的差异。在纳入的149例pwMS患者中,8.1%被确定为可能患有PTSD。这些患者在大流行前出现异常焦虑(66.7%对18.5%,<0.001)和抑郁评分(45.5%对12.6%,=0.013)的比例显著更高。可能患有PTSD的患者表现出独特的人格特征,神经质和回避伤害得分显著更高,而尽责性、合作性和自我导向得分更低。与未患有可能PTSD的患者相比,他们在大流行期间报告严重或非常严重的心理/身体/社会负担的可能性也显著更高(≤0.045)。应提供医疗和社会服务以支持经历严重压力或创伤的患者。在制定教育和疫苗接种程序的概念时,应同时进行全面且清晰的沟通,识别个体风险因素,并用基于证据且有说服力的论据解决可能存在的担忧。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56e0/12027752/f093d4dd049e/jcm-14-02665-g001.jpg

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