Dor Neuropática e Processos de Regulação Emocional em Doentes com o Diagnóstico de Esclerose Múltipla: um modelo preditivo dos sintomas psicopatológicos de depressão
Bibliographic record
Abstract
Introdução: A Esclerose Múltipla (EM) é uma doença neurológica crónica, desmielinizante do sistema nervoso central. Esta doença tem um curso progressivo e, normalmente, gera incapacidade. A depressão é uma perturbação mental de elevada comorbilidade com a EM. Todavia, ainda são escassos os estudos acerca dos preditores da depressão em pacientes com EM. Objetivo: O presente estudo propôs-se a explorar o valor preditivo da dor neuropática e de processos de regulação emocional disfuncionais - supressão do pensamento, alexitimia, fusão cognitiva e atitude autocrítica - para o desenvolvimento de sintomatologia depressiva em portadores de EM. Método: Este estudo transversal integrou os seguintes grupos de participantes: 100 doentes com o diagnóstico de EM e sem outros diagnósticos do foro neurológico (grupo clínico com EM) e 110 indivíduos da população geral sem outras doenças neurológicas identificadas (grupo da população geral sem EM). Esta última amostra destinou-se a caracterizar os participantes com EM comparativamente aos participantes sem EM relativamente às variáveis em estudo e a construir o modelo preditivo. Os dois grupos responderam aos seguintes questionários de autorresposta: Questionário Sociodemográfico e Clínico Para Doentes Com Esclerose Múltipla, Pain Detect Questionnaire (PD-Q); Depression, Anxiety and Stress Scale (DASS-21), Toronto Alexithymia Scale (TAS-20), Cognitive Fusion Questionnaire (CFQ), Self-Compassion Scale (SCS) e o White Bear Suppression Inventory (WBSI). Resultados: O grupo clínico com EM caracterizou-se por apresentar valores significativamente superiores de sintomatologia depressiva e em relação a todos os potenciais preditores. O modelo preditivo é estatisticamente significativo, explicando cerca de 23% da variância dos sintomas depressivos em doentes com EM, tendo retido como preditor significativo a atitude autocrítica. Discussão: Intervenções psicológicas com o objetivo de prevenir e reduzir a depressão em pacientes com EM devem incluir estratégias destinadas a flexibilizarem uma atitude autocrítica enquanto processo de regulação emocional. A terapia Focada na Compaixão é promissora para este fim, contribuindo, assim, para a promoção da saúde mental na referida população clínica e para a eventual minimização da progressão da EM. / Introduction: Multiple sclerosis (MS) is a chronic neurological disease, demyelinating of the central nervous system. This disease has a progressive course and usually generates disability. Depression is a mental disorder with high comorbidity with MS. However, studies on predictors of depression in MS patients are still scarce. Objective: The present study aimed to explore the predictive value of neuropathic pain, dysfunctional emotional regulation processes - suppression of thought, alexithymia, cognitive fusion and self-critical attitude – in the development of depressive symptoms in MS patients. Method: This cross-sectional study included the following participant groups: 100 patients diagnosed with MS (clinical group with MS) and without other neurological diagnoses and 110 individuals from the general population without other identified neurological diseases (group from the general population without MS). This last sample was intended to characterize participants with MS compared to participants without MS in relation to the variables under study and to build the predictive model. Both groups answered the following self-answer questionnaires: Sociodemographic and Clinical Questionnaire for Patients with Multiple Sclerosis, Pain Detect Questionnaire (PD-Q); Depression, Anxiety and Stress Scale (DASS-21), Toronto Alexithymia Scale (TAS-20), Cognitive Fusion Questionnaire (CFQ), Self-Compassion Scale (SCS) and the White Bear Suppression Inventory (WBSI). Results: The clinical group with MS was characterized by presenting significantly higher values of depressive symptoms and in relation to all potential predictors. The model is statistically significant, explaining about 23% of the variance of depressive symptoms in patients with MS, having retained the self-critical attitude as a significant predictor. Discussion: Psychological interventions aimed at preventing and reducing depression in patients with MS should include strategies aimed at making a self-critical attitude more flexible as a process of emotional regulation. The therapy focused on compassion is promising for this purpose, thus contributing to the promotion of mental health in the referred clinical population and to the possible minimization of the progression of MS.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.023 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.006 | 0.009 |
| Science and technology studies | 0.004 | 0.003 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.005 | 0.002 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".