文章摘要

多发性硬化患者心理状况及其影响因素

作者: 1杨若澜, 1史明英, 1张奕玲
1 四川大学华西医院神经内科/四川大学华西护理学院,成都 610041
通讯: 杨若澜 Email: zhangtt_123456@163.com
DOI: 10.3978/j.issn.2095-6959.2020.10.025

摘要

目的:调查分析多发性硬化(multiple sclerosis,MS)患者的心理状况及影响因素。方法:选取2018年1月至2019年10月于四川大学华西医院神经内科住院符合调查条件的150例MS患者,采用汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)及汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)评价患者抑郁、焦虑心理状况,由经过统一培训的医护人员展开调查,共发放150份问卷,回收147份有效问卷,有效率为98.00%。统计患者性别、年龄、婚姻、文化程度、病程、吸烟、饮酒、家庭人均月收入、家庭功能、医疗费用支付方式、复发次数、疾病分类及病变累及部位等一般情况,并采用躯体残疾程度调查量表(Expanded disability Status Scale,EDSS)评价患者躯体致残程度。结果:147例患者HAMD,HAMA评分分别为10.82±2.56和7.46±2.28;62例(42.18%)有抑郁状况,其中可能抑郁40例(27.21%),肯定抑郁17例(11.56%),严重抑郁7例(4.76%);54例(36.73%)有焦虑状况,其中可能焦虑31例(21.09%),肯定焦虑18例(12.24%),严重焦虑5例(3.40%);单因素分析结果显示:MS患者抑郁状况与病程、复发次数、疾病分类及EDSS评分相关(P<0.05),焦虑状况与病程、家庭功能、复发次数、疾病分类及EDSS评分相关(P<0.05);多因素logistic分析结果显示:病程、复发次数、疾病分类及EDSS评分为影响MS患者抑郁状况的独立危险因素;病程、家庭功能、复发次数、疾病分类及EDSS评分为影响MS患者焦虑状况的独立危险因素。结论:MS患者多伴抑郁、焦虑等负性情绪障碍,且病程、家庭功能、复发次数、疾病分类及躯体残疾程度均可影响患者心理状况,临床上不仅要给予药物治疗,还要重视心理干预治疗。
关键词: 多发性硬化;心理状况;抑郁;焦虑;影响因素

Psychological status of patients with multiple sclerosis and its influencing factors

Authors: 1YANG Ruolan, 1SHI Mingying, 1ZHANG Yiling
1 Department of Neurology, West China Hospital/West China School of Nursing, Sichuan University, Chengdu 610041, China

CorrespondingAuthor: YANG Ruolan Email: zhangtt_123456@163.com

Abstract

Objective: To investigate and analyze psychological status and influencing factors of patients with multiple sclerosis (MS). Methods: From January 2018 to October 2019, 150 MS patients meeting the survey conditions who were admitted to the Department of Neurology of West China Hospital were enrolled. Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were applied to evaluate depression and anxiety. The survey was conducted by medical staffs undergoing unified training. A total of 150 questionnaires were distributed, and 147 valid questionnaires were collected, with effective rate of 98.00%. The general conditions such as gender, age, marriage, education level, course of disease, smoking, drinking, monthly income, number of recurrences, disease types, and lesion involved sites were statistically analyzed. The degree of physical disability was assessed by Expanded Disability Status Scale (EDSS). Results: Of 147 patients, scores of HAMD and HAMA were 10.82±2.56 and 7.46±2.28, respectively. There were 62 patients (42.18%) with depression, including 40 cases (27.21%) with possible depression, 17 cases (11.56%) with definite depression, and 7 cases (4.76%) with severe depression. There were 54 cases (36.73%) with anxiety, including 31 cases (21.09%) with possible anxiety, 18 cases (12.24%) with definite anxiety, and 5 cases (3.40%) with severe anxiety. Univariate analysis showed that depression status of MS patients was correlated with course of disease, recurrence frequency, disease classification, and EDSS score (P<0.05), while anxiety status was correlated with course of disease, family function, recurrence frequency, disease classification, and EDSS score (P<0.05). Multivariate logistic analysis showed that course of disease, recurrence frequency, disease classification, and EDSS score were independent risk factors for depression in MS patients, while course of disease, family function, recurrence frequency, disease classification, and EDSS score were independent risk factors for anxiety in MS patients. Conclusion: MS patients are often accompanied with negative emotional disorders such as depression and anxiety. The course of disease, family function, recurrence frequency, disease classification, and degree of physical disability can all affect the psychological status of patients. Clinically, not only drug treatment should be given, but also psychological intervention treatment should be payed attention to.
Keywords: multiple sclerosis; psychological status; depression; anxiety; influencing factor