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首页> 外文期刊>Patient Preference and Adherence >Interrelationship between depression, anxiety, pain, and treatment adherence in hemophilia: results from a US cross-sectional survey
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Interrelationship between depression, anxiety, pain, and treatment adherence in hemophilia: results from a US cross-sectional survey

机译：血友病患者的抑郁症，焦虑症，疼痛和治疗依从性之间的相互关系：美国一项横断面调查的结果

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Purpose: Depression, anxiety, pain, and treatment adherence have reciprocal effects not characterized extensively in hemophilia. This study explored the relationships between depression, anxiety, chronic pain, and treatment adherence in adults with hemophilia. Patients and methods: Adults with self-reported hemophilia A or B completed the cross-sectional IMPACT QoL II survey. Depression (9-item Patient Health Questionnaire [PHQ-9]), anxiety (7-item Generalized Anxiety Disorder scale [GAD-7]), chronic pain (Faces Pain Scale–Revised [FPS-R]), social support (Duke UNC Functional Social Support questionnaire), level of pain control, clotting factor treatment adherence (VERITAS-Pro or -PRN), and previous depression/anxiety were analyzed. Results: Among 200 participants (male, 77.3%; female, 22.8%), 54% had PHQ-9 and 52% had GAD-7 scores indicating moderate to severe depression or anxiety without diagnosis of either disorder. Participants with PHQ-9 scores ≥10 (moderate to severe depression) were more likely to have lower treatment adherence than those with PHQ-9 scores 10 ( P 0.05). Participants with PHQ-9 or GAD-7 scores ≥10 were more likely to report uncontrolled pain and less social support versus PHQ-9 or GAD-7 scores 10 (χsup2/sup P 0.05). Significant correlations were found between PHQ-9 and GAD-7 ( P 0.0001), PHQ-9 and FPS-R ( P =0.0004), PHQ-9 and VERITAS ( P =0.01), GAD-7 and FPS-R ( P =0.02), and GAD-7 and VERITAS ( P= 0.001). Conclusion: Depression and anxiety are underdiagnosed in hemophilia. Depression is associated with anxiety, pain, and lower treatment adherence. While treatment providers play an important role in diagnosis, social workers may play a pivotal role in depression and anxiety screening. This study highlights the importance of regular screening and treatment for these disorders.
机译：目的：抑郁症，焦虑症，疼痛和依从性治疗具有相互影响，而血友病患者并未广泛体现。这项研究探讨了成人血友病患者抑郁，焦虑，慢性疼痛与治疗依从性之间的关系。患者和方法：自我报告为A型或B型血友病的成年人完成了IMPACT QoL II横断面调查。抑郁症（9项患者健康问卷[PHQ-9]），焦虑症（7项广义焦虑症量表[GAD-7]），慢性疼痛（面部疼痛量表修订[FPS-R]），社会支持（杜克大学UNC功能社会支持问卷），疼痛控制水平，凝血因子治疗依从性（VERITAS-Pro或-PRN）和先前的抑郁/焦虑症进行了分析。结果：在200名参与者中（男性，占77.3％;女性，占22.8％），有54％的患者具有PHQ-9，有52％的患者的GAD-7评分表明中度至重度抑郁或焦虑而未诊断出任何一种疾病。 PHQ-9得分≥10（中度至重度抑郁）的参与者比PHQ-9得分<10的参与者更有可能降低治疗依从性（P <0.05）。与PHQ-9或GAD-7得分<10（PH 2 P <0.05）相比，PHQ-9或GAD-7得分≥10的参与者更有可能表现出不受控制的疼痛和较少的社会支持。在PHQ-9和GAD-7（P <0.0001），PHQ-9和FPS-R（P = 0.0004），PHQ-9和VERITAS（P = 0.01），GAD-7和FPS-R（ P = 0.02）和GAD-7和VERITAS（P = 0.001）。结论：血友病患者对抑郁和焦虑的诊断不足。抑郁症与焦虑，疼痛和较低的治疗依从性有关。尽管治疗提供者在诊断中起着重要作用，但社会工作者在抑郁症和焦虑症筛查中可能起关键作用。这项研究强调了定期筛查和治疗这些疾病的重要性。

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