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Ouwerkerk M, Rietberg MB, van der Linden MMW, Uitdehaag BMJ, van Wegen EEH, de Groot V. Mood Associated With Health- and Social Care-Related Quality of Life in Patients With Advanced Multiple Sclerosis. Int J MS Care 2024; 26:199-206. [PMID: 39091383 PMCID: PMC11293463 DOI: 10.7224/1537-2073.2023-060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
BACKGROUND Individuals with advanced multiple sclerosis (MS) have complex care requirements and are more likely to use long-term facilities. This study determined the associations between mood and social care-related quality of life (SCRQOL), and health-related quality of life (HRQOL) and examined the association between HRQOL and SCRQOL. METHODS Baseline data from a cohort study were used. Patients completed questionnaires, including the Hospital Anxiety and Depression Scale (HADS), Adult Social Care Outcomes Toolkit (ASCOT), and EuroQOL 5D-5L (EQ-5D-5L) and EQ-Visual Analogue Scale (EQ-VAS). Linear regression analyses were employed to assess the relationships between mood and both outcomes of QOL while controlling for relevant confounding factors (βs; 95% CI). The cross-sectional association between SCRQOL and HRQOL was examined using Pearson correlation coefficients (r). RESULTS A total of 75 patients, with a mean age of 56.1 years and a disease duration of 17.3 years, were enrolled from a long-term care facility in the Netherlands. Results showed that after controlling for confounders, HADS is an independent determinant of ASCOT (βs = -.368; 95% CI, -.581 to -.154) and EQ-5D-5L (βs = -.297; 95% CI, -.507 to -.087). Also, there are significant but weak correlations between ASCOT and EQ-5D-5L (r = 0.242; 95% CI, .015-.468), between ASCOT and EQ-VAS (r = 0.230; 95% CI, .003-.457) and between EQ-5D-5L and EQ-VAS (r = 0.227; 95% CI, .000-.454). CONCLUSIONS Mood, especially the depression component, is an important determinant of both HRQOL and SCRQOL in advanced MS. Focusing on mood in health care and social care may contribute to the improvement of QOL in a broader sense.
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Affiliation(s)
- Maaike Ouwerkerk
- Department of Rehabilitation Medicine, Neurosciences, MS Center Amsterdam, Amsterdam University Medical Center, Amsterdam, the Netherlands
- Nieuw Unicum, Zandvoort, the Netherlands
| | - Marc B. Rietberg
- From the Department of Rehabilitation Medicine, Amsterdam Movement Sciences, MS Center Amsterdam, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Meike M. W. van der Linden
- Department of Rehabilitation Medicine, Neurosciences, MS Center Amsterdam, Amsterdam University Medical Center, Amsterdam, the Netherlands
- Nieuw Unicum, Zandvoort, the Netherlands
| | - Bernard M. J. Uitdehaag
- Department of Neurology, Neurosciences, MS Center Amsterdam, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Erwin E. H. van Wegen
- From the Department of Rehabilitation Medicine, Amsterdam Movement Sciences, MS Center Amsterdam, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Vincent de Groot
- From the Department of Rehabilitation Medicine, Amsterdam Movement Sciences, MS Center Amsterdam, Amsterdam University Medical Center, Amsterdam, the Netherlands
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Neto LO, Ruiz JA, Gromisch ES. Perceived health- related quality of life in persons with multiple sclerosis with and without a vascular comorbidity. Qual Life Res 2024; 33:573-581. [PMID: 37966685 DOI: 10.1007/s11136-023-03546-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 11/16/2023]
Abstract
PURPOSE Vascular comorbidities are prevalent and can contribute to adverse health outcomes in persons with multiple sclerosis (PwMS). Understanding the association between vascular comorbidities and health-related quality of life (HRQOL) among PwMS may be beneficial in improving outcomes and disease management. This cross-sectional study aimed to examine the relationship between vascular comorbidities and the different dimensions of HRQOL in PwMS. METHODS Participants (n = 185) were PwMS recruited from a community-based comprehensive MS care center. Demographics, comorbid conditions, and disability level were collected via a self-report REDCap survey, with the 29-item Multiple Sclerosis Quality of Life (MSQOL-29) as the outcome measure. Regression models were used to examine the association between vascular comorbidities and the MSQOL-29, controlling for age, gender, ethnicity, level of education, marital status, MS subtype, disease duration, and disability. RESULTS Approximately 35% reported at least one vascular comorbidity, with the most common being hypertension (27.0%), followed by hyperlipidemia (24.9%) and diabetes (8.1%). After factoring in for demographics and disability, having a vascular comorbidity was associated with lower physical HRQOL (β = - 10.05, 95% CI: - 28.24, 23.50), but not mental HRQOL (β = - 2.61, 95% CI: - 10.54, 5.32). Hypertension was negatively associated with several dimensions of HRQOL, including Physical Function, Change in Health, Health Perceptions, Energy, and Health Distress. CONCLUSIONS Having at least one vascular comorbidity is associated with lower physical HRQOL, independent of demographics and level of physical disability. Focus should be directed to the physical burden and challenges vascular comorbidities may cause on the lives of PwMS.
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Affiliation(s)
- Lindsay O Neto
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, 490 Blue Hills Avenue, Hartford, CT, 06112, USA.
- Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at, Quinnipiac University, North Haven, CT, USA.
| | - Jennifer A Ruiz
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, 490 Blue Hills Avenue, Hartford, CT, 06112, USA
- Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at, Quinnipiac University, North Haven, CT, USA
- Department of Medical Sciences, Frank H. Netter MD School of Medicine at, Quinnipiac University, North Haven, CT, USA
| | - Elizabeth S Gromisch
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, 490 Blue Hills Avenue, Hartford, CT, 06112, USA
- Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at, Quinnipiac University, North Haven, CT, USA
- Department of Medical Sciences, Frank H. Netter MD School of Medicine at, Quinnipiac University, North Haven, CT, USA
- Department of Neurology, University of Connecticut School of Medicine, Farmington, CT, USA
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Kołtuniuk A, Pawlak B, Krówczyńska D, Chojdak-Łukasiewicz J. The quality of life in patients with multiple sclerosis - Association with depressive symptoms and physical disability: A prospective and observational study. Front Psychol 2023; 13:1068421. [PMID: 36687950 PMCID: PMC9853525 DOI: 10.3389/fpsyg.2022.1068421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/16/2022] [Indexed: 01/07/2023] Open
Abstract
Background Patients with multiple sclerosis (MS) experience disabilities which significantly affect their quality of life (QOL) and mental health. Mood disorders and depressive symptoms are one of the most common psychiatric conditions in MS patients. This study aimed to evaluate the level of QOL in MS patients and to assess the influence of depressive symptoms and physical disability on QOL. Methods This prospective and observational study was conducted among 100 MS patients (mean age of 36.23 ± 11.77) recruited from the Lower Silesian Unit of the Polish Association for Multiple Sclerosis. This study used a questionnaire designed by the authors, which contained questions about sociodemographic and clinical data, as well as the following standardized questionnaires: the Activities of Daily Living questionnaire (ADL), the Instrumental Activities of Daily Living questionnaire (IADL), the Expanded Disability Status Scale (EDSS), the Beck Depression Inventory (BDI) and Multiple Sclerosis International Quality of Life Questionnaire (MusiQOL). Results The average EDSS score among patients was 3.13 ± 2.38 points. More than half of the respondents (68%) suffered from depression of varying severity. The univariate linear regression models showed that the independent (p < 0.05) QOL predictors (total MusiQOL) were as follows: the number of complaints, IADL results, BDI results, EDSS score, higher education, and material status >2000 PLN. In addition, the multiple linear regression model showed that the BDI result was a significant predictor of QOL (p < 0.005). Conclusion Depressive symptoms significantly affect the QOL of MS patients.
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Affiliation(s)
- Aleksandra Kołtuniuk
- Division of Internal Medicine Nursing, Wroclaw Medical University, Wroclaw, Poland
| | - Beata Pawlak
- Division of Internal Medicine Nursing, Wroclaw Medical University, Wroclaw, Poland
| | - Dorota Krówczyńska
- Cardinal Stefan Wyszynski Institute of Cardiology, Warsaw, Poland
- Department of Nursing and Obstetrics Collegium Mazovia, Siedlce, Poland
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Gil-González I, Martín-Rodríguez A, Conrad R, Pérez-San-Gregorio MÁ. Quality of life in adults with multiple sclerosis: a systematic review. BMJ Open 2020; 10:e041249. [PMID: 33257490 PMCID: PMC7705559 DOI: 10.1136/bmjopen-2020-041249] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE In recent years, quality of life (QoL) in multiple sclerosis (MS) has been gaining considerable importance in clinical research and practice. Against this backdrop, this systematic review aimed to provide a broad overview of clinical, sociodemographic and psychosocial risk and protective factors for QoL in adults with MS and analyse psychological interventions for improving QoL. METHOD The literature search was conducted in the Scopus, Web of Science and ProQuest electronic databases. Document type was limited to articles written in English, published from January 1, 2014, to January 31, 2019. Information from the selected articles was extracted using a coding sheet and then qualitatively synthesised. RESULTS The search identified 4886 records. After duplicate removal and screening, 106 articles met the inclusion and exclusion criteria for qualitative synthesis and were assessed for study quality. Disability, fatigue, depression, cognitive impairment and unemployment were consistently identified as QoL risk factors, whereas higher self-esteem, self-efficacy, resilience and social support proved to be protective. The review analysed a wide spectrum of approaches for QoL psychological intervention, such as mindfulness, cognitive behavioural therapy, self-help groups and self-management. The majority of interventions were successful in improving various aspects of QoL. CONCLUSION Adequate biopsychosocial assessment is of vital importance to treat risk and promote protective factors to improve QoL in patients with MS in general care practice.
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Affiliation(s)
- Irene Gil-González
- Personality, Assessment, and Psychological Treatment, University of Seville, Seville, Spain
| | | | - Rupert Conrad
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
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Rintala A, Matcham F, Radaelli M, Locafaro G, Simblett S, Barattieri di San Pietro C, Bulgari V, Burke P, Devonshire J, Weyer J, Wykes T, Comi G, Hotopf M, Myin-Germeys I. Emotional outcomes in clinically isolated syndrome and early phase multiple sclerosis: a systematic review and meta-analysis. J Psychosom Res 2019; 124:109761. [PMID: 31443806 DOI: 10.1016/j.jpsychores.2019.109761] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/02/2019] [Accepted: 07/03/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To study depression, anxiety, suicide risk, and emotional health-related quality of life (HRQoL) in people with clinically isolated syndrome (CIS) and in early phase multiple sclerosis (MS). METHODS A systematic literature review was conducted with inclusion criteria of observational studies on outcomes of depression, anxiety, suicide risk, and emotional HRQoL in CIS and within five years since diagnosis of MS. Studies were screened using the Preferred Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, and study quality was determined for included studies. Meta-analysis and meta-regression were performed if applicable. RESULTS Fifty-one studies were included in the systematic review. In early phase MS, meta-analyses of the Hospital Anxiety Depression Scale (HADS) indicated prevalence levels of 17% (95% confidence interval (CI): 9 to 25%; p < .001) for depressive and 35% (95% CI: 28 to 41%; p < .001) for anxiety symptoms. Meta-regression analyses revealed an increase in mean HADS-D and HADS-A associated with larger sample size, and higher HADS-D mean with increased study quality. Similar depressive and anxiety symptoms were observed in CIS, and increased suicide risk and low emotional HRQoL was associated with depressive symptoms in early phase MS. The methodological quality of the studies was considered fair. CONCLUSIONS Findings suggest that mild-to-moderate symptoms of depression and anxiety might be prevalent in CIS and in early phase MS. Future research on both clinical populations are needed, especially longitudinal monitoring of emotional outcomes.
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Affiliation(s)
- A Rintala
- Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium.
| | - F Matcham
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
| | - M Radaelli
- Department of Neurology, San Raffaele Hospital, Milan, Italy.
| | - G Locafaro
- Department of Neurology, San Raffaele Hospital, Milan, Italy
| | - S Simblett
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
| | - C Barattieri di San Pietro
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; Dipartimento di Psicologia, Università di Milano-Bicocca, Milan, Italy.
| | - V Bulgari
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
| | - P Burke
- The Remote Assessment of Disease and Relapse in Central Nervous System Disorders (RADAR-CNS) Patient Advisory Board.
| | - J Devonshire
- The Remote Assessment of Disease and Relapse in Central Nervous System Disorders (RADAR-CNS) Patient Advisory Board.
| | - J Weyer
- The Remote Assessment of Disease and Relapse in Central Nervous System Disorders (RADAR-CNS) Patient Advisory Board
| | - T Wykes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
| | - G Comi
- Department of Neurology, San Raffaele Hospital, Milan, Italy.
| | - M Hotopf
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
| | - I Myin-Germeys
- Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium.
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Moravejolahkami AR, Paknahad Z, Chitsaz A. Association of dietary patterns with systemic inflammation, quality of life, disease severity, relapse rate, severity of fatigue and anthropometric measurements in MS patients. Nutr Neurosci 2019; 23:920-930. [DOI: 10.1080/1028415x.2019.1580831] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Zamzam Paknahad
- Department of Clinical Nutrition, School of Nutrition & Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Chitsaz
- Department of Neurology, Isfahan University of Medical Sciences Isfahan, Iran
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