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Neurological disability, psychological distress, and health-related quality of life in MS patients within the first three years after diagnosis

Department of Neurology, University Hospital Carl Gustav Carus at the Technische Universität Dresden, GermanySimone.Kern{at}uniklinikum-dresden.de

W Schrempf

Department of Neurology, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Germany

H Schneider

Department of Neurology, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Germany

T Schultheiß

Department of Neurology, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Germany

H Reichmann

Department of Neurology, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Germany

T Ziemssen

Department of Neurology, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Germany

Background

Psychological distress and psychiatric co-morbidity are common in multiple sclerosis (MS) and is often associated with neurological disability as well as reduced quality of life.

Objectives

This study aimed to investigate psychological distress and the possible association with quality of life as well as neurological disability in MS patients within the first 3 years after diagnosis.

Methods

Psychological distress was measured using a standardized questionnaire (Symptom-Check-List-90-R; SCL-90-R) in 31 relapsing–remitting MS patients and 24 sex- and age-matched healthy controls.

Results

Psychological distress was significantly more pronounced in MS patients when compared to healthy controls. Interpersonal sensitivity and psychoticism were positively associated with neurological disability (Expanded Disability Status Scale [EDSS]). A high EDSS group (median split EDSS; 1.5) expressed significantly more psychological distress when compared to the low EDSS group and healthy controls. MS patients with minimal to no neurological disability (low EDSS group) also expressed significantly more emotional distress when compared to healthy controls. MS-related quality of life was positively associated with neurological disability as well as SCL-90-R scores. After adjusting for neurological disability, psychological distress was still significantly associated with quality of life.

Conclusions

Early stage MS patients significantly differ in their psychological distress when compared to healthy controls. Psychological distress in these patients is associated with neurological disability, but it is also present in patients with minimal to no neurological disability. Psychological distress was identified as an independent predictor for MS-related quality of life.

Key Words: anxiety • depression • EDSS • multiple sclerosis • neurological disability • psychiatric symptoms • psychological distress • quality of life • stress

Multiple Sclerosis, Vol. 15, No. 6, 752-758 (2009)
DOI: 10.1177/1352458509103300


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