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S. M. Maca, A. Sobala, G. Kahraman, G. Pakesch, T. Barisani; HLA-B27 Antigen-Associated Acute Anterior Uveitis (B27-AAU), Coping Mechanisms and the Subjective Impression of Stress as a Trigger: New Insights. Invest. Ophthalmol. Vis. Sci. 2008;49(13):795.
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Patients with B27-AAU often report a relation between recurrences of inflammation and psychological factors. We therefore designed a study comparing B27-AAU patients according to the time interval since the last uveitis attack. Aim of this study was to find out whether the occurrence of flare-ups can be related to individual coping mechanisms, depressive tendencies, stress and/or specific life events.
This clinic-based, cross-sectional study was performed at the uveitis unit of the Medical University of Vienna from January to June 2006. 171 patients filled in a booklet containing international and standardized psychological questionnaires (Freiburg Questionnaire of Coping with Illness (FQCI), Beck Depression Inventory (BDI), Stress Coping Inventory (SVF 120)) as well as a sociodemographic data sheet and questions about stress/trigger situations.
Uveitis patients did not reveal any abnormal psychological profiles, however 57.9% believed that stress triggered uveitis recurrences. Individual provoking situations were death in family, separation from a partner, illness, job cancellation or -changes.Patients were divided into three groups according to the time point of their last uveitis recurrence: 69 patients (40.4%) <= 1 year, 44 (25.7 %) 1-3 yrs and 58 (33.9%) >3 yrs. An univariate regression analysis could not demonstrate any association between test scores and time interval. The number of life events showed a positive correlation with depressive coping styles (FQCI, r=0.3, p<0.01), depressive tendencies (BDI, r=0.2, p<0.01) as well as more frequent and longer lasting uveitis recurrences (both r=0.2, p<0.05).Patients, however, who subjectively could identify stress situations as triggers for uveitis recurrences expressed a lower tendency for depressive moods (BDI, r=-0.2, p<0.01), lesser tendency for depressive coping (FQCI, r=-0.3, p<0.01) or negative coping strategies (SVF 120, r=-0.2, p<0.01).
Despite the fact that our patients did not exhibit coarse deviations of questionnaire-based psychological profiles concerning disease coping strategies, 57.9% of patients believed in stress as a trigger factor for uveitis recurrences, 35% of patients could even name a specific (positive or negative) life event having preceded an uveitis attack. Besides professional medical care, psychic support, education of the patient and of persons caring for him, and preparation to self-care should be an integral part of therapy to improving the quality of life of our patients.
Clinical Trial: :
274/2005 Ethics Committee,Medical Univ Vienna,274/2005
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