肌萎缩侧索硬化患者心理健康状况与影响因素分析

Analysis of the mental health situation and risk factors in amyotrophic lateral sclerosis patients

目的调查肌萎缩侧索硬化(amyotrophic lateral sclerosis,ALS)患者心理健康状况及共病情绪障碍情况,为患者及时获得心理及药物治疗提供依据。方法选择2011年9月至2015年2月在我院诊治的ALS患者72例作为病例组,选择同期在我院进行体检的性别及年龄匹配的健康者72例作为对照组,收集两组患者一般情况,对两组进行心理学量表测评,调查其共病焦虑抑郁情况。结果 ALS组的汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)和汉密尔顿抑郁量表-17项(Hamilton rating scale for depression,HRSD-17)评分分别为(41.22±1.45)分和(40.56±2.89)分,而对照组两个量表评分分别为(28.59±2.10)分和(24.20±3.14)分,ALS组明显高于对照组(P<0.05)。ALS患者共病睡眠障碍、焦虑障碍和抑郁障碍的比例分别为36.1%、33.3%和31.9%,均明显高于同年龄段对照组(分别为5.6%、4.2%和2.8%)。Pearson相关分析结果显示,修订版ALS功能评分量表(ALS functional ratingscale-revised,ALSFRS-R)与心理状况评分呈明显相关性(P<0.05);logistic回归分析显示病程、受教育程度、ALS-FRS-R评分为主要的影响因素(P<0.05)。结论 ALS患者合并严重的抑郁情绪问题,且抑郁情绪与患者疾病病程、受教育年限、病情直接相关,需要得到及时的干预。

Objective To investigate the mental health situation in amyotrophic lateral sclerosis（ALS） patients and analyze the relevant factors. Methods From September 2011 to February 2015, 72 ALS patients in the Chinese PLA General Hospital were involved as ALS group, and other 72 subjects without ALS were recruited as the control group. The general information of all subjects was collected and the neuropsychological scales assessment was conducted for all subjects to investigate the existence of depressive comorbidity in the ALS patients and the related risk factors. Results The HAMA scores in ALS group were significantly higher than those of the control group（41.22 ± 1.45 vs. 28.59 ± 2.10, P〈0.05）. The HRSD- 17 scores in ALS group were significantly higher than those of the control group（40.56 ± 2.89 vs.24.20 ± 3.14, P〈0.05）. ALS patients comorbidity with sleep disorder, depression disorder and anxiety disorder were36.1%, 33.3% and 31.9% separately, which were higher than those of the control group（which were 5.6%, 4.2% and 2.8%separately）. Pearson correlation analysis showed that ALSFRS- R score was significantly correlated to the mental status score（P〈0.05）. Logistic regression analysis showed that disease duration, level of education, ALS scores were the main factors（P〈0.05）. Conclusion ALS patients are easy to have depression and need timely intervention, considering the risk factor including disease duration, level of education, ALSFRS-R scores.