Anxiety, Depression, and Quality of Life: A Long-Term Follow-Up Study of Patients with Persisting Concussion Symptoms
Anxiety, Depression, and Quality of Life: A Long-Term Follow-Up Study of Patients with Persisting Concussion Symptoms
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DOI：
10.1089/neu.2020.7313
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发表时间：
2020-11-02
影响因子：
4.2
通讯作者：
Tator, Charles H.
中科院分区：
文献类型：
--
作者：
Doroszkiewicz, Corinne;Gold, David;Tator, Charles H.
持续的脑震荡症状（PCS）可以持续数月，数年，或无限期地影响相当多的脑震荡患者。本研究的目的是评估在加拿大脑震荡中心接受检查的患者中焦虑和抑郁临床症状的患病率以及PCS与生活质量之间的关系。将抑郁与焦虑压力量表-42 （DASS-42）和世界卫生组织生活质量评估量表- bref （WHOQOL-BREF）发送给526名确诊为PCS的成年患者。四分位数间随访时间中位数为5（4-7）年。在105名受访者中，35.2%的人表现出轻微或更严重的焦虑、抑郁症状，或两者兼而有之。重要的是，先前脑震荡的次数与DASS-42焦虑（p = 0.030）和抑郁（p = 0.018）亚量表得分的升高相关，表明症状的获得性原因。与DASS-42得分正常的患者相比，临床抑郁、焦虑或两者均有升高的患者在每个领域的WHOQOL-BREF平均得分较低（p < 0.001）。这些发现表明，PCS患者的抑郁和焦虑可以持续数年，并与生活质量下降有关。因此，抑郁和焦虑应该在PCS人群中及早识别和治疗，以优化恢复。虽然在目前的研究中，抑郁和焦虑的潜在病因还不能确定，但抑郁和焦虑与脑震荡次数之间的联系可能表明了一种有机的解释。未来，生活质量测量应纳入PCS的治疗和研究中，以改进干预策略并加强对该人群康复轨迹的了解。
Persisting concussion symptoms (PCS) can last for months, years, or indefinitely and affect a considerable number of concussion patients. The objectives of this study were to evaluate the prevalence of clinical symptoms of anxiety and depression and the relationship between PCS and quality of life in patients examined at the Canadian Concussion Centre. The Depression and Anxiety Stress Scale-42 (DASS-42) and the World Health Organization Quality of Life Assessment-BREF (WHOQOL-BREF) were sent to 526 adult patients diagnosed with PCS. Median with interquartile range follow-up time was 5 (4-7) years. Of the 105 respondents, 35.2% displayed mild or greater symptoms of anxiety, depression, or both. Importantly, the number of previous concussions was correlated with elevations on the DASS-42 Anxiety (p = 0.030) and Depression (p = 0.018) subscale scores, suggesting an acquired cause of symptoms. Patients with clinical elevations of depression, anxiety, or both exhibited poorer mean WHOQOL-BREF scores in each domain (p < 0.001) compared to those who scored in the normal range on the DASS-42. These findings indicate that depression and anxiety in PCS can endure for years and are associated with diminished quality of life. Consequently, depression and anxiety should be identified and treated early in PCS populations in order to optimize recovery. Although the underlying etiology of depression and anxiety cannot be ascertained with certainty in the present study, the association between depression and anxiety and the number of concussions may indicate an organic explanation. In the future, quality-of-life measures should be incorporated into treatment and research in PCS to improve intervention strategies and enhance understanding of the trajectory of recovery in this population.