与多发性硬化症患者抑郁和焦虑有关的人格和认知因素:系统回顾和荟萃分析

Rebekah A. Davenport , Isabel Krug , Nicole Rickerby , Phuong Linh Dang , Elizabeth Forte , Litza Kiropoulos
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引用次数: 0

摘要

背景抑郁和焦虑在多发性硬化症(plwMS)患者中很普遍,并且与不良预后结果有关。认知理论认为,人格和认知因素会带来抑郁和焦虑的风险。本荟萃分析综述旨在综合与多发性硬化症患者抑郁和焦虑相关的人格和认知因素的证据,并确定社会人口学和临床变量是否会缓和因素与症状之间的关系。方法本系统综述、荟萃分析和荟萃回归均为前瞻性注册(CRD42020192253)。通过数据库检索(Medline、Embase、PsycInfo、WebofScience、Proquest)确定了相关文献,如果这些文献包含临床确诊的多发性硬化症患者样本(年龄≥11岁)、抑郁或焦虑测量指标以及人格或认知因素,则予以考虑。结果 共有 99 项研究被纳入叙述性综述(97 个样本;N= 13,609; Mage= 44.20±7.26),77 项研究对 24 个因素产生了影响,并进行了随机效应元分析。抑郁和焦虑与较高的神经质、较低的外向性、情绪失调、对多发性硬化症严重后果的疾病认知以及对多发性硬化症的强烈认同之间的关系最为密切(r's=0.28-0.59)。一组因素表现出抑郁的特异性,包括心理不灵活(r= 0.62)和乐观(r= -0.43)。局限性由于数据有限,无法对所有病例的异质性进行评估,也无法得出前瞻性结论。结论研究结果强调了抑郁和焦虑的共同因素和不同因素,为有针对性的干预措施提供了启示。
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Personality and cognitive factors implicated in depression and anxiety in multiple sclerosis: A systematic review and meta-analysis

Background

Depression and anxiety are prevalent among persons living with multiple sclerosis (plwMS) and are linked to negative prognostic outcomes. Cognitive theories posit that personality and cognitive factors confer risk for depression and anxiety. This meta-analytic review aimed to synthesise evidence on personality and cognitive factors related to depression and anxiety in MS and determine whether sociodemographic and clinical variables moderate factor-symptom relations.

Methods

This systematic review, meta-analysis and meta-regression was prospectively registered (CRD42020192253). Publications were identified through database searches (Medline, Embase, PsycInfo, WebofScience, Proquest) and considered if they included a sample of individuals with clinically definite MS (age ≥11 years) and a measure of depression or anxiety and a personality or cognitive factor. The Newcastle-Ottawa Scale was applied to assess methodological rigor.

Results

A total of 99 studies were included in the narrative synthesis (97 samples; N= 13,609; Mage= 44.20±7.26), with 77 contributing effects on 24 factors for random-effects meta-analyses. The most robust relationships were between depression and anxiety and higher neuroticism, lower extraversion, emotion dysregulation, and illness perceptions of serious MS consequences and a strong MS identity (r's=0.28–0.59). A set of factors exhibited specificity for depression, including psychological inflexibility (r= 0.62) and optimism (r= -0.43). Relationships varied as a function of age, gender, and MS-type.

Limitations

Limited data availability prevented evaluation of heterogeneity in all cases, and prospective conclusions. Exclusion criteria in the included studies reduced the generalisability findings.

Conclusions

Findings highlight shared and distinct factors implicated in depression and anxiety, offering insights for tailored interventions.

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来源期刊
Journal of Affective Disorders Reports
Journal of Affective Disorders Reports Psychology-Clinical Psychology
CiteScore
3.80
自引率
0.00%
发文量
137
审稿时长
134 days
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