Drent M, Wirnsberger R M, Breteler M H, Kock L M, de Vries J, Wouters E F
Department of Pulmonology, University Hospital Maastricht, The Netherlands.
Sarcoidosis Vasc Diffuse Lung Dis. 1998 Mar;15(1):59-66.
Apart from the disease status, chronically ill patients are confronted with stressors like dependence, limitations in mobility and physical complaints. Data on patients with sarcoidosis, however, are lacking. The aim of this study was to investigate the quality of life (QOL) and the influence of QOL factors on depressive symptoms in these patients.
Sixty-four patients with histologically proven sarcoidosis participated in this study. Significant co-morbidity was excluded. The Sickness Impact Profile (SIP) was used to determine the QOL. Depressive symptoms were measured with the Beck Depression Inventory (BDI), of which a subset of items measured cognitive symptoms, the Cognitive Depression Index (CDI). Disease status was assessed by pulmonary function parameters (FEV1, Dco), complaints and illness duration. To control for a confounding cognitive style of self-report, the Positive Affect Negative Affect Schedule (PANAS) was administered.
The major complaint was fatigue. QOL was related to the perception of complaints, but not to the assessed disease status. In a multivariate regression 86% of the variance could be explained in BDI-scores, and 83% in CDI-scores. After controlling for demographical factors, disease status and cognitive style, QOL contributed to the regression, explaining another 17% of variance of BDI-scores as well as CDI-scores. Problems with sleeping were associated positively with depressive symptoms in general (beta = 0.38) and depressive cognitions only (beta = 0.32).
In sarcoidosis, QOL factors were associated with depressive symptoms. These results suggest that patients with sarcoidosis may profit from attention to the psychosocial as well as the somatic aspects of this disease.
除疾病状况外，慢性病患者还面临诸如依赖、行动不便和身体不适等压力源。然而，关于结节病患者的数据却很缺乏。本研究的目的是调查这些患者的生活质量（QOL）以及QOL因素对抑郁症状的影响。
64例经组织学证实为结节病的患者参与了本研究。排除了显著的合并症。使用疾病影响量表（SIP）来确定生活质量。用贝克抑郁量表（BDI）测量抑郁症状，其中一部分项目测量认知症状，即认知抑郁指数（CDI）。通过肺功能参数（FEV1、Dco）、症状和病程评估疾病状况。为控制自我报告中可能存在的混淆认知风格，使用了正负性情绪量表（PANAS）。
主要症状是疲劳。生活质量与对症状的感知有关，而与评估的疾病状况无关。在多变量回归中，BDI得分的86%和CDI得分的83%的方差可以得到解释。在控制了人口统计学因素、疾病状况和认知风格后，生活质量对回归有贡献，分别解释了BDI得分和CDI得分另外17%的方差。睡眠问题总体上与抑郁症状呈正相关（β = 0.38），仅与抑郁认知呈正相关（β = 0.32）。
在结节病中，生活质量因素与抑郁症状相关。这些结果表明，结节病患者可能会从关注该疾病的心理社会和躯体方面中受益。
