Anxiety and depression in Multiple Sclerosis (MS): Antecedents, consequences, and differential impact on well-being and quality of life

Objective: The cross-sectional study evaluated the psychometric properties of the Functional Assessment of Multiple Sclerosis (FAMS) Spanish version and its use in measuring quality of life (QOL) of multiple sclerosis (MS) patients in Spain. Methods: The FAMS is a factorially derived self-report scale designed to assess six primary aspects of QOL of patients with MS: Mobility, Symptoms, Emotional Well-Being, General Contentment, Thinking and Fatigue, and Family/Social Well-Being. Its Spanish translated version was used to assess QOL of 625 MS patients recruited in an outpatient clinic setting from 58 hospitals in Spain. Internal consistency of the Spanish FAMS was evaluated. Multiple regression analyses were performed to identify significant predictors from demographic, clinical and treatment characteristics, and Kurtzke Expanded Disability Status Scale (EDSS) scores in predicting FAMS scale scores. Results: Most of the patients are females (66%), and 74% were of the relapsing-remitting (RR) clinical subtype. Cronbach’s alpha coefficients were high (range=0.78-0.96), indicating subscale homogeneity comparable to that of the original English version. Linear multivariate regression analyses revealed that the EDSS is a dominant variable in predicting all the FAMS subscales, especially mobility (R2=0.51) and the total scores. Conclusions: The Spanish FAMS is a psychometrically valid instrument that allows clinicians and clinical researchers the ability to measure the QOL concerns of MS patients in Spain.

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P–478 Quality of life assessment in women undergoing assisted reproduction. A study of FertiQol and HADS

Human Reproduction ◽

10.1093/humrep/deab130.477 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

N Figueras-Puigderrajols ◽

A Ballesteros ◽

D Guerra

Keyword(s):

Quality Of Life ◽

Depression Scale ◽

Well Being ◽

Self Esteem ◽

Mobile App ◽

Life Assessment ◽

Fertility Treatment ◽

Anxiety And Depression ◽

Gamete Donation

Abstract Study question The present study aims to explore infertility-related psychosocial outcomes, including fertility quality of life (QoL), as well as anxiety and depression levels, in women diagnosed with infertility. Summary answer Differences on fertility-related QoL appeared when comparing treatment types (gamete donation vs own gamete). Furthermore, statistically significant associations were found between QoL and anxious-depressive symptomatology. What is known already Those who wish to have children and do not achieve their objective just like other peers can see their goals and expectations with pessimism, generating concern and a series of negative emotions. Several psychological implications of infertility have been described, such as increased levels of stress, anxiety, depression, decreased self-esteem, mood and hope, or poor relationship adjustment. The emotional impact of infertility in people’s life cycle can be so strong that reducing it only to biological aspects would lead to a dangerous situation of neglect. For this reason, QoL assessment in ART becomes an important need. Study design, size, duration FertiQol stands as the most widely used tool to assess infertility-related QoL, overcoming the limitations of other instruments that only target specific medical conditions. The present is a multi-site cross-sectional study over patients with infertility (n = 104), aiming to explore their fertility-QoL, as well as their anxiety and depression levels, which are symptoms that have been previously associated.Questionnaire administration, and sociodemographic and medical data gathering took place between January 2019 and December 2020. Participants/materials, setting, methods Participants were 104 female patients (M.age= 39.8) undergoing or expecting a fertility treatment. The FertiQol Spanish version was administered through mobile app, and its paper version distributed at medical/psychological appointments. QoL was self-reported through FertiQol, assessing the influence of infertility problems in various areas (e.g. impact on self-esteem, emotions, general health, family, partners, social relationships, work, life projects...). Additionally, HADS (Hospital Anxiety and Depression Scale) was provided as a measurement of anxiety and depression levels. Main results and the role of chance Regarding treatments, 50.6% of participants were currently undergoing gamete donation while 44.3% were undergoing treatments that involved using their own gametes. After comparing QoL between these treatment types, results showed that patients who underwent egg donation, compared to those who used their own eggs, reported statistically significantly lower scores of QoL in the Social Subscale (p = .03), but not in the other psychological outcomes. Also, statistically significant negative correlations were found between HADS and all core FertiQol subscales (p< .05). Results are consistent with previous studies showing similar associations between fertility QoL and anxiety and depression, as well as with increased psychological negative implications of gamete donation. The majority of participants reported non-pathological scores of anxiety and depression when considering the cut off value of 8 for HADS, thus suggesting the presence of a relatively healthy sample. The number of treatments that patients had previously taken and the years of infertility were not associated with any of the psychological variables. Limitations, reasons for caution Some limitations to consider are presence of co-morbid diagnosis, differences in medication, or patient’s cultural backgrounds.Also, conclusions should be interpreted cautiously since the design doesn’t allow causal inferences. Further investigations should consider a continuous assessment to explore changes in psychological well-being at different points of intervention, specially with gamete donation. Wider implications of the findings: The great advantage we’ve seen so far when using FertiQol is the possibility to identify more accurately the true impact on other aspects of patient’s well-being besides the emotional area.ART professionals, including psychologists and counselors,will have more information within a small amount of time about QoL when using this tool. Trial registration number 1503-BCN–019-DG

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Health-Related Quality of Life of Patients with Multiple Sclerosis in Oman – A CrossSectional Study

Oman Medical Journal ◽

10.5001/omj.2021.109 ◽

2021 ◽

Author(s):

Jansirani Natarajan ◽

Mickael Antoine Joseph ◽

Abdullah Al Asmi ◽

Gerald Amandu Matua ◽

Jaber Al Khabouri ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Disease Process ◽

Well Being ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

The Impact ◽

Disease Specific

Objectives: Multiple sclerosis is a disabling neurological disorder with significant negative effects on patients’ quality of life. Despite the increased prevalence of multiple sclerosis in Arabian Gulf countries in recent years, no study has assessed the impact of multiple sclerosis on the healthrelated quality of life of Omani patients. Therefore, the objectives of the current study was to assess the impact of multiple sclerosis on the health-related quality of life of Omani patients using the validated disease-specific self-administered MusiQoL instrument. Methods: A cross-sectional descriptive study was carried out between April and December 2019 on 177 Omani patients with multiple sclerosis attending two major hospitals in Oman. Patients’ health-related quality of life was assessed using the validated disease-specific self-administered MusiQoL instrument. Results: Majority (51.4%) of the patients had poor HRQOL and 48.6% had moderate HRQOL. We found that being older than 30 years, a female, married, separated, widowed, or divorced, and having visual and sleep problems had poorer health-related quality of life. Among the different health-related quality of life components, relationship with the healthcare system and relationship with family and friends were the most affected because of the disease process. Our results also showed that psychological well-being and coping domains of MusiQoL questionnaires are significantly reduced in females as compared to males. Conclusion: Understanding the health-related quality of life of Omanis with multiple sclerosis provides valuable knowledge that could help optimize the management of this disease.

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Art therapy possibilities in the complex treatment of patients with multiple sclerosis

Neurology neuropsychiatry Psychosomatics ◽

10.14412/2074-2711-2021-1s-45-49 ◽

2021 ◽

Vol 13 (1S) ◽

pp. 45-49

Author(s):

M. E. Guseva ◽

O. V. Matvievskaya ◽

A. N. Boyko

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Art Therapy ◽

Anxiety And Depression ◽

Cycle Duration ◽

Blue Color ◽

Complex Treatment ◽

Light Blue ◽

Sf 36

Objective: to study the effectiveness of art therapy methods in the complex treatment of neuropsychological disorders and quality of life improvement in patients with relapsing-remitting and secondary-progressive multiple sclerosis (MS).Patients and methods. A group of 42 patients (5 men and 37 women, mean age 32.9 years, mean EDSS severity 3.8 points) with MS underwent outpatient continuous active art therapy cycle. The mean group training cycle duration was six months. The comparison group included 15 age- and sex-adjusted individuals without neurological disorders. Tests on various drawing topics were carried out before and after a three-month therapy course. We used Hospital Anxiety and Depression Scale (HADS) to assess the severity of anxiety and depression and the SF-36 scale to evaluate the quality of life (QoL).Results and discussion. Before the art therapy start, light blue, yellow, pink, blue, and green colors prevailed in the drawings. There was no predominance of any color depending on MS severity or course. The green color predominated in this test in the control group, and the light blue color was significantly less represented. The art therapy course did not lead to a significant change in the severity of MS according to the Expanded Disability Status Scale (EDSS). After the art therapy course, the color scheme of the drawings was mainly represented by red, light blue, green, yellow, and blue colors. In addition, a red-orange color appeared in the drawings, which was completely absent before the course. Positive trends were noted according to HADS: a decrease in anxiety by 23% and depression by 19%. The physical component of QoL assessed by the SF-36 scale did not change substantially, but the psychological component significantly improved by 11%.Conclusion. The predominance of light blue color observed in MS is associated with damage to the nervous and musculoskeletal systems, and blue color – with psychological problems and depression. However, after a course of art therapy for MS, red, red-orange, yellow, and green colors representation increased significantly, which indicates an increase in positive attitude, a decrease in the level of depression, and an improvement in QoL.

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Enhancing quality of life in progressive multiple sclerosis with powered robotic exoskeleton

Multiple Sclerosis Journal ◽

10.1177/1352458520943080 ◽

2020 ◽

pp. 135245852094308

Author(s):

Seng Kwee Wee ◽

Chiu Yi Ho ◽

Si Lei Tan ◽

Cheng Hong Ong

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Well Being ◽

Gait Training ◽

Self Esteem ◽

Progressive Multiple Sclerosis ◽

Robotic Exoskeleton ◽

Lower Limb Strength ◽

Training Post

Wearable powered robotic exoskeleton can provide high repetitions and high-intensity gait training. It can promote a sense of well-being when the user is in upright posture to walk around different environment. We present a case of a lady with progressive multiple sclerosis who received 15 sessions of robotic exoskeleton training. Post training, she demonstrated improvement in lower limb strength, sense of well-being and self-esteem that led to improved transfer ability, increased social outings and better quality of life (QOL). Previously, she was depressed and reluctant to go out for social activities. This case suggests the potential of robotic exoskeleton to enhance QOL in people with mobility challenges.

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Pain Characteristics and Associations with Quality of Life in Patients with Multiple Sclerosis in Lithuania

Medicina ◽

10.3390/medicina56110596 ◽

2020 ◽

Vol 56 (11) ◽

pp. 596

Author(s):

Greta Veličkaitė ◽

Neringa Jucevičiūtė ◽

Renata Balnytė ◽

Ovidijus Laucius ◽

Antanas Vaitkus

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Neuropathic Pain ◽

Short Form ◽

Depression Scale ◽

Structured Interview ◽

Anxiety And Depression ◽

Control Group ◽

And Control

Background and objectives: Even though pain in multiple sclerosis (MS) patients is common and possibly associated with reduced quality of life, its exact prevalence and characteristics remain vaguely understood. We aimed to estimate the true extent of pain and its associations with quality of life in Lithuanian MS patients and to compare this data with that of a control group. Materials and Methods: Data were collected prospectively at the Department of Neurology, Lithuanian University of Health Sciences Kaunas Clinics. A face-to-face structured interview and a questionnaire were used to collect demographic and clinical data of the MS (n = 120) and control (n = 120) groups. The Expanded Disability Status Scale (EDSS) was used to quantify disability in the MS group. Scores ≥4/10 in the Douleur Neuropathique 4 questionnaire were classified as neuropathic pain. Patients were evaluated using the anxiety and depression subsets of the Hospital Anxiety and Depression Scale (HADS-A and HADS-D), the physical and mental component subsets of the Short Form-12 questionnaire (PSC-12 and MSC-12). Results: The MS and control groups did not differ in pain prevalence (76.7% vs. 65.9%, p = 0.064) or intensity. Lhermitte sign, lower limb, and face pain were more common in the MS group, whereas subjects in the control group were more often affected by lower back, neck, and joint pain. Neuropathic pain and pain lasting longer than 2 years were more common among pain-affected MS patients than among controls. MS patients with pain had higher EDSS, HADS-D, and HADS-A and lower PSC-12 scores than those without pain; however, no difference was found regarding the duration of MS or age. Males with MS and pain had higher MSC-12 and HADS-D scores in comparison to the same subset of females. Conclusions: Pain affects approximately three out of four patients with MS in Lithuania and is negatively associated with the mental and physical aspects of quality of life.

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Fatigue, quality of life, and cognitive functions in metastatic kidney cancer patients with antiangiogenic treatment.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.7_suppl.328 ◽

2011 ◽

Vol 29 (7_suppl) ◽

pp. 328-328 ◽

Cited By ~ 1

Author(s):

S. Noal ◽

M. Lange ◽

B. J. Escudier ◽

E. Sevin ◽

S. Dauchy ◽

...

Keyword(s):

Quality Of Life ◽

Working Memory ◽

Episodic Memory ◽

Executive Functions ◽

Cancer Patients ◽

Cognitive Functions ◽

Well Being ◽

Anxiety And Depression ◽

Over Time

328 Background: Fatigue is commonly reported by patients under anti-angiogenic therapies, with sometimes cognitive complains. However, few studies have explored these problems. A longitudinal multicentric prospective study is ongoing in France on fatigue, cognitive functions, quality of life (QoL), anxiety and depression among metastatic kidney cancer patients receiving anti-angiogenic therapies. Objectives: The main objective is to assess fatigue. Secondary objectives are to assess cognitive functions, QoL, anxiety, and depression. Methods: Assessments are made at baseline, at 3 and 6 months. Evaluations were made by: autoquestionnaire MFI-20 to assess fatigue, FACT-G and FKSI to assess QoL, Spielberger's and Beck's questionnaires to assess respectively anxiety and depression. Cognitive functions were assessed by a neuropsychologist with the Working Memory Index (WAIS-III), Grober and Buschke test, Rey Complexe Figure test, verbal fluency and Trail Making test, exploring respectively working memory, episodic memory and executive functions. Preliminary results are presented. Results: 35 patients were enrolled, and 20 of them had the second assessment at 3 months. Most of patients received sunitinib (51%), others received bevacizumab and interferon, or sorafenib. At baseline, 45% of patients expressed general fatigue and 50% at 3 months (p=0.04). Other domains of fatigue (physical, mental, reduced activity and motivation) did not change over time. At baseline, few patients had cognitive disorders (working memory 6%; executive functions 0%; episodic memory 11%), with no decline at 3 months. However, there was an impairment of QoL in FKSI score (p=0.01) and of FACT-G physical well-being (p=0.01). No differences were found in social, emotional or functional well-being. There was no difference on depression nor on anxiety over time. Conclusions: Fatigue significantly increased during the first 3 months of anti-angiogenic treatment, with no impact on cognitive functions but a decline of QoL. These preliminary findings need to be confirmed by further follow-up and more patients. Final results will be provided with 120 patients. No significant financial relationships to disclose.

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Efficacy of meaning-centered group psychotherapy for cancer survivors: a randomized controlled trial

Psychological Medicine ◽

10.1017/s0033291717000447 ◽

2017 ◽

Vol 47 (11) ◽

pp. 1990-2001 ◽

Cited By ~ 27

Author(s):

N. van der Spek ◽

J. Vos ◽

C. F. van Uden-Kraan ◽

W. Breitbart ◽

P. Cuijpers ◽

...

Keyword(s):

Quality Of Life ◽

Cancer Survivors ◽

Group Psychotherapy ◽

Well Being ◽

Personal Meaning ◽

Anxiety And Depression ◽

Post Intervention ◽

Psychological Well Being ◽

Mental Adjustment

BackgroundThe aim of this study was to assess the efficacy of meaning-centered group psychotherapy for cancer survivors (MCGP-CS) to improve personal meaning, compared with supportive group psychotherapy (SGP) and care as usual (CAU).MethodA total of 170 cancer survivors were randomly assigned to one of the three study arms: MCGP-CS (n = 57); SGP (n = 56); CAU (n = 57). The primary outcome measure was the Personal Meaning Profile (PMP; total score). Secondary outcome measures were subscales of the PMP, psychological well-being (Scales of Psychological Well-being; SPWB), post-traumatic growth (Posttraumatic Growth Inventory), Mental Adjustment to Cancer (MAC), optimism (Life Orientation Test-Revised), hopelessness (Beck's Hopelessness Scale), psychological distress (anxiety and depression, Hospital Anxiety and Depression Scale; HADS) and quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire; EORTC QLQ-C30). Outcome measures were assessed before randomization, post-intervention, and after 3 and 6 months of follow-up (FU).ResultsLinear mixed model analyses (intention-to-treat) showed significant differences between MCGP-CS, SGP and CAU on the total PMP score, and on (sub)scales of the PMP, SPWB, MAC and HADS. Post-hoc analyses showed significantly stronger treatment effects of MCGP-CS compared with CAU on personal meaning (d = 0.81), goal-orientedness (d = 1.07), positive relations (d = 0.59), purpose in life (d = 0.69); fighting spirit (d = 0.61) (post-intervention) and helpless/hopeless (d = −0.87) (3 months FU); and distress (d = −0.6) and depression (d = −0.38) (6 months FU). Significantly stronger effects of MCGP-CS compared with SGP were found on personal growth (d = 0.57) (3 months FU) and environmental mastery (d = 0.66) (6 months FU).ConclusionsMCGP-CS is an effective intervention for cancer survivors to improve personal meaning, psychological well-being and mental adjustment to cancer in the short term, and to reduce psychological distress in the long run.

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Can Aerobic Exercise Training Affect Health-Related Quality of Life for People with Multiple Sclerosis?

Journal of Sport and Exercise Psychology ◽

10.1123/jsep.23.2.122 ◽

2001 ◽

Vol 23 (2) ◽

pp. 122-135 ◽

Cited By ~ 31

Author(s):

Georgina Sutherland ◽

Mark B. Andersen ◽

Mark A. Stoové

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Bodily Pain ◽

Well Being ◽

Exercise Group ◽

Control Group ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Individuals with multiple sclerosis (MS) are often advised not to participate in vigorous exercise. Leading a relatively sedentary life, however, may exacerbate the debilitating effects of MS. In this study, 22 people participated in either a no-special-activity group (n = 11) or an experimental group (n = 11) that involved water aerobics three times a week for 10 weeks. Measures taken included scales for health-related quality of life (HRQOL) and psychological well-being. ANCOVAs using social support and the appropriate pretest scores as covariates revealed that after the intervention, the exercise group had more energy and vigor (extremely large effect sizes). Other very large effects were found in the exercise group, which had better social and sexual functioning and less bodily pain and fatigue than the control group. Future research should involve long-term studies to determine whether exercise not only improves quality of life but also helps slow the progression of disease.

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The relation between the experience of time and psychological distress in patients with hematological malignancies

Palliative & Supportive Care ◽

10.1017/s1478951506060469 ◽

2006 ◽

Vol 4 (4) ◽

pp. 357-363 ◽

Cited By ~ 42

Author(s):

MARC WITTMANN ◽

TANJA VOLLMER ◽

CLAUDIA SCHWEIGER ◽

WOLFGANG HIDDEMANN

Keyword(s):

Quality Of Life ◽

Psychological Distress ◽

Hematological Malignancies ◽

Well Being ◽

Anxiety And Depression ◽

Life Threatening Illness ◽

Experience Of Time ◽

Spiritual Well Being ◽

Life Threatening

Objective: The experience of time is strongly related to our momentary mood states. Patients with a life-threatening illness experience an extreme change in mood and suffer from psychological distress that can develop into clinically relevant psychiatric disorders, like anxiety and depression. The aim of this study was to investigate the associations among the subjective perception of time, psychological distress, and quality of life in patients with hematological malignancies.Methods: Eighty-eight inpatients with hematological malignancies rated how fast time passes subjectively on a visual analog scale and prospectively estimated a time span of 13 min. The Hospital Anxiety and Depression Scale (HADS) self-report measures of health-related quality of life (FACT-G) and spiritual well-being (FACIT-Sp) were employed to assess psychological distress and quality of life.Results: Those patients who reported a lower quality of life, less spiritual well-being, and more anxiety experienced a slower passage of subjective time and overestimated the 13-min time interval.Significance of results: Our interpretation of the results is that patients with a life-threatening illness who show symptoms of psychological distress draw attention away from meaningful thoughts and actions and, thus, experience time as passing more slowly. An altered sense of time can be a sign of mental suffering, which should be addressed within psycho-oncological interventions. As this is the first study to demonstrate this relation in cancer patients, further research is needed to investigate the experience of time and its relation to meaning as an issue in clinical diagnostics.

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