系统性自身免疫性类风湿性疾病中神经精神症状的患病率和鉴定:一项国际混合方法研究
Melanie Sloan1, Chris Wincup2, Rupert Harwood3
1Department of Public Health and Primary Care Unit, University of Cambridge, Cambridge, UK.
Rheumatology (Oxford, England)
|July 26, 2023
概括
系统性自身免疫性类风湿性疾病 (SARD) 患者报告的神经精神病症状明显高于对照组. 临床医生大大低估了这些症状,强调需要更好的沟通和患者参与SARD护理.
科学领域:
- 类风湿病学 类风湿病学
- 神经精神病学是一种神经精神病学.
- 临床心理学 临床心理学
背景情况:
- 系统性自身免疫性类风湿性疾病 (SARDs) 与有限范围的报告的神经精神病症状有关.
- 多样化的症状患病率需要对SARS的神经精神疾病表现进行更广泛的调查.
研究的目的:
- 与之前的研究相比,研究SARS患者的神经精神症状范围更广.
- 为了比较患者自我报告的症状与临床医生的估计.
- 探索在SARD中识别神经精神病症状的障碍.
主要方法:
- 采用混合方法方法,将SARD患者 (n=1853) 的数据与对照组 (n=463) 和临床医生 (n=289) 的数据进行比较.
- 对深度访谈 (n=113) 进行了主题分析.
- 统计测试比较了患者组,对照组和临床医生专业之间的调查数据.
主要成果:
- 与对照组相比,SARD患者报告了所有30个研究的神经精神病症状 (认知,感觉运动,精神病) 的终身患病率明显高.
- 经过验证的仪器显示,目前55%的SARD患者患有抑郁症,57%的患者患有焦虑症.
- 障碍包括有限的知识,指导方针,客观测试,跨专业合作,症状主观性和报告/文档不足. 与被问及的患者 (74%) 相比,临床医生很少询问心理健康问题 (4%),患者很少报告症状 (50%+),临床医生低估了这些症状 (<10%).
结论:
- 神经精神病症状的患病率在SARD患者中明显高于对照组,并且被临床医生低估.
- 当前的研究和指导方针可能无法准确地捕捉患者的神经精神病学经验.
- 改善跨专业沟通和患者参与对于SARD的护理和研究至关重要.
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