Association Among Facial Paralysis, Depression, and Quality of Life in Facial Plastic Surgery Patients.
Association Among Facial Paralysis, Depression, and Quality of Life in Facial Plastic Surgery Patients.
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DOI：
10.1001/jamafacial.2016.1462
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发表时间：
2017-05-01
影响因子：
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通讯作者：
Ishii LE
中科院分区：
文献类型：
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作者：
Nellis JC;Ishii M;Byrne PJ;Boahene KDO;Dey JK;Ishii LE
虽然有传闻，但很少有研究调查面瘫对抑郁症和生活质量（QOL）的影响。测量在面部整形外科诊所寻求治疗的患者中抑郁、生活质量和面瘫之间的关系。前瞻性地收集了2013年至2015年期间最初到面部整形外科诊所就诊的全因面瘫患者和对照患者的数据。对照组包括到面部整形外科诊所进行评估的异质性患者人群。既往接受过面部复苏手术或缺失人口统计学和心理测量学数据的患者被排除在分析之外。对两组的人口统计学、面瘫病因、面瘫严重程度（House-Brackmann量表分级）、Beck抑郁量表和QOL评分进行了检查。潜在的混杂因素，包括自我报告的吸引力和情绪，收集和分析。使用0至100视觉模拟量表测量自我报告的评分。共分析了263例患者（平均年龄48.8岁; 66.9%为女性）。对照组175例，面瘫组88例。面瘫组和对照组的性别分布无显著差异。面神经麻痹患者有明显更高的抑郁，更低的自我报告的吸引力，更低的情绪和更低的生活质量评分。总体而言，37名面瘫患者（42.1%）筛查出抑郁症阳性，与13名对照患者（8.1%）相比，House-Brackmann 3级或更高级别患者的可能性最大（比值比，10.8; 95%CI，5.13-22.75）（P <0.001）。在多变量回归中，面瘫和女性与较高的抑郁评分显著相关（常数，2.08 [95%CI，0.77-3.39];面瘫效应，5.98 [95%CI，4.38-7.58];女性效应，1.95 [95%CI，0.65-3.25]）。面瘫与较低的QOL评分相关（常数，81.62 [95%CI，78.98-84.25];面瘫效应，-16.06 [95%CI，-20.50至-11.62]）。对于寻求治疗的患者，面瘫与抑郁增加和生活质量评分下降显著相关。此外，女性与抑郁评分的增加显著相关。此外，面瘫严重程度较高的患者更有可能筛查出抑郁症阳性。临床医生最初评估患者时应考虑面瘫的心理影响，以优化护理。2.
Though anecdotally linked, few studies have investigated the impact of facial paralysis on depression and quality of life (QOL). To measure the association between depression, QOL, and facial paralysis in patients seeking treatment at a facial plastic surgery clinic. Data were prospectively collected for patients with all-cause facial paralysis and control patients initially presenting to a facial plastic surgery clinic from 2013 to 2015. The control group included a heterogeneous patient population presenting to facial plastic surgery clinic for evaluation. Patients who had prior facial reanimation surgery or missing demographic and psychometric data were excluded from analysis. Demographics, facial paralysis etiology, facial paralysis severity (graded on the House-Brackmann scale), Beck depression inventory, and QOL scores in both groups were examined. Potential confounders, including self-reported attractiveness and mood, were collected and analyzed. Self-reported scores were measured using a 0 to 100 visual analog scale. There was a total of 263 patients (mean age, 48.8 years; 66.9% were female) were analyzed. There were 175 control patients and 88 patients with facial paralysis. Sex distributions were not significantly different between the facial paralysis and control groups. Patients with facial paralysis had significantly higher depression, lower self-reported attractiveness, lower mood, and lower QOL scores. Overall, 37 patients with facial paralysis (42.1%) screened positive for depression, with the greatest likelihood in patients with House-Brackmann grade 3 or greater (odds ratio, 10.8; 95% CI, 5.13–22.75) compared with 13 control patients (8.1%) (P < .001). In multivariate regression, facial paralysis and female sex were significantly associated with higher depression scores (constant, 2.08 [95% CI, 0.77–3.39]; facial paralysis effect, 5.98 [95% CI, 4.38–7.58]; female effect, 1.95 [95% CI, 0.65–3.25]). Facial paralysis was associated with lower QOL scores (constant, 81.62 [95% CI, 78.98–84.25]; facial paralysis effect, −16.06 [95% CI, −20.50 to −11.62]). For treatment-seeking patients, facial paralysis was significantly associated with increased depression and worse QOL scores. In addition, female sex was significantly associated with increased depression scores. Moreover, patients with a greater severity of facial paralysis were more likely to screen positive for depression. Clinicians initially evaluating patients should consider the psychological impact of facial paralysis to optimize care. 2.