Razi Journal of Medical Sciences
مجله علوم پزشکی رازی
RJMS
Medical Sciences
http://rjms.iums.ac.ir
39
journal39
2228-7043
2228-7051
en
jalali
1398
6
1
gregorian
2019
9
1
26
6
online
1
fulltext
fa
بررسی مقایسه ای نشانگان روانشناختی در بیماران مولتیپل اسکلروزیس و افراد بهنجار
Comparison of Psychological Symptoms in Multiple Sclerosis Patients and Normal People
روانپزشکی
Psychiatry
پژوهشي
Research
<strong><span style="color:#0070C0;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">زمینه و هدف: </span></span></span></strong><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">بیماری ام.اس ماهیت مزمن و</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">پیشرونده</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">دارد</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">و بر جنبه­های</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">مختلف</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">زندگی</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">فرد</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">تأثیر</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">می­گذارد و در نتیجه مشکلات روانشناختی و کاهش کیفیت زندگی را به­همراه دارد. </span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">با توجه به اهمیت این موضوع این مطالعه با هدف بررسی نشانگان اختلالات روانشناختی در بیماران ام.اس و مقایسه آن­ها با گروه گواه انجام شد. </span></span></span><br>
<strong><span style="color:#0070C0;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">روش­ کار:</span></span></span></strong><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"> این مطالعه به روش علی- مقایسه­ای در </span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">بیماران مبتلا به ام.اس و افراد سالم استان گیلان انجام شد. به­منظور انجام پژوهش 120 بیمار ام.اس و 120 فرد سالم در این مطالعه مشارکت داشتند. جهت جمع­آوری داده­ها از </span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">چک لیست نشانه­های بیماری 90 سوالی تجدید نظر شده استفاده شد. تحلیل داده­ها با استفاده از نرم­افزار </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">SPSS-22</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"> و آزمون یو</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">من- ویتنی انجام شد. </span></span></span><br>
<strong><span style="color:#0070C0;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">یافتهها:</span></span></span></strong> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">بررسی نقطه برش برای </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">GSI</span></span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">نشان داد که 68 نفر (66/56%) از بیماران ام.اس و 23 نفر (16/19%) از افراد سالم مشکوک به اختلالات روانشناختی بودند. نتایج بررسی نشانگان اختلالات روانشناختی دلالت بر این داشت که میانگین رتبه­ای اختلالات جسمانی­سازی (001/0></span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">p</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 471/4-=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">Z</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 4798=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">U</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">)، وسواس فکری- عملی (001/0></span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">p</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 118/5-=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">Z</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 500/4450=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">U</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">)، حساسیت بین­فردی (001/0></span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">p</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 893/4-=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">Z</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 500/4572=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">U</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">)، افسردگی (001/0></span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">p</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 513/4-=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">Z</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 500/4775=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">U</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">)، اضطراب (001/0></span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">p</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 219/5-=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">Z</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 500/4360=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">U</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">)، خصومت (001/0></span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">p</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 204/5-=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">Z</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 500/4411=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">U</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">)، فوبیا (001/0></span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">p</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 945/3-=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">Z</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 500/5099=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">U</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">)، پارانویا (001/0></span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">p</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 401/3-=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">Z</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 5375=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">U</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">)، روان­پریشی (001/0></span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">p</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 689/5-=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">Z</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 500/4154=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">U</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">)، و میانگین رتبه­ای </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">GSI</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"> (001/0></span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">p</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 597/5-=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">Z</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">، 419=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">U</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">)</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">در بیماران ام.اس به­طور معنادار بیشتر از افراد سالم بود. </span></span></span><br>
<strong><span style="color:#0070C0;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">نتیجهگیری:</span></span></span></strong><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"> در مجموع نتایج نشان داد که نشانگان روانشناختی در افراد مبتلا به ام.اس بیشتر از افراد بهنجار میباشد. باتوجه به اینکه مسائل روانشناختی نقش موثری بر فرایند درمان این افراد دارد، براین اساس غربالگری و ارائه مداخلات روان­درمانی مبتنی بر نشانگان روانشناختی این بیماران توصیه می­شود.</span></span></span><br>
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<strong>Background:</strong> MS disease has a chronic and progressive nature and affects various aspects of a person's life, and results in psychological problems and poor quality of life in patients. Considering the importance of this issue, this study aimed to investigate the psychological symptoms in MS patients compared with the control group.<br>
<strong>Methods:</strong> This is a causal-comparative study in patients with MS and healthy individuals in Guilan province. In this study, 120 MS patients and 120 healthy people participated in this study. To collect the data, the Symptom CheckList-90- Revised (SCL-90-R) was used. Data were analyzed by using SPSS v.22 software and Mann–Whitney U test.<br>
<strong>Results:</strong> A survey of cut-off points for GSI showed that 68 (56.66%) of MS patients and 23 (19.16%) of healthy people were suspected of psychological disorders. The results of psychological disorder symptoms indicate that the mean score of the somatization (U=4798, Z=-4.471, p<0.001), obsessive–compulsive disorder (U=4450.500, Z=-5.118, p<0.001), interpersonal sensitivity (U=4572.500, Z=-4.893, p<0.001), Depression (U= 4775.500, Z=-4.513, p<0.001), anxiety (U=4360.500, Z=-5.219, p<0.001), hostility (U=4411.500, Z=-5.204, p<0.001), phobia (U=5099.500, Z=-3.945, p<0.001), paranoia (U=5375, Z=-3.401, p<0.001), pychoticism (U=4154.500, Z=-5.689, p<0.001) mean score of GSI (U=419, Z=-5.597, p<0.001) in MS patients were significantly more than healthy people.<br>
<strong>Conclusion: </strong>Overall, the results showed that the psychological symptom was more common in people with MS than normal people. By considering this fact, the psychological issues have an effective role in the treatment of these individuals, however the recommendation is screening and psychosocial interventions based on the psychological symptom of these patients.<br>
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مولتیپل اسکلروزیس, اختلالات روانشناختی, استان گیلان
Multiple sclerosis, Mental disorders, Guilan province
73
83
http://rjms.iums.ac.ir/browse.php?a_code=A-10-4421-1&slc_lang=fa&sid=1
Sajjad
Saadat
سجاد
سعادت
sajjadsaadat69@gmail.com
3900319475328460046125
3900319475328460046125
No
University of Isfahan, Isfahan, Iran
دانشگاه اصفهان، اصفهان، ایران
Mehrdad
Kalantari
مهرداد
کلانتری
mehrdadk@edu.ui.ac.ir
3900319475328460046126
3900319475328460046126
Yes
University of Isfahan, Isfahan, Iran
دانشگاه اصفهان، اصفهان، ایران
Mohammad Bagher
Kajbaf
محمدباقر
کجباف
m.b.kaj@edu.ui.ac.ir
3900319475328460046127
3900319475328460046127
No
University of Isfahan, Isfahan, Iran
دانشگاه اصفهان، اصفهان، ایران
Mozaffar
Hosseininezhad
مظفر
حسینی نژاد
hosseininezhadm@gmail.com
3900319475328460046128
3900319475328460046128
No
Clinical Research Development Unit Poursina, Guilan University of Medical Sciences, Rasht, Iran
دانشگاه علوم پزشکی گیلان، رشت، ایران