Assessment of Life Satisfaction in Patients with Clinically Isolated Syndrome

Czech version

Authors: E. Hynčicová ¹; M. Vyhnálek ¹;  t. Nikolai ¹; J. Hort ¹;  e. Meluzínová ¹; J. Laczó ¹
Authors‘ workplace: Neurologická klinika 2. LF UK a FN Motol, Praha ¹
Published in: Cesk Slov Neurol N 2017; 80(6): 675-678
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn2017675

Overview

Objective:
Our aim was to evaluate life satisfaction in patients with clinically isolated syndrome (CIS) and its association with depression, anxiety, cognitive difficulties and severity of disability.

Subjects and methods:
We assessed life satisfaction with Questionnaire of Life Satisfaction (QLS), cognitive difficulties with Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ), depression and anxiety with Beck Depression Inventory (BDΙ) and Beck Anxiety Inventory (BAI) in 60 patients with CIS and 42 healthy volunteers. The Expanded Disability Status Scale (EDSS) was used to evaluate severity of disability in patients with CIS.

Results:
We found lower total QLS score and lower specific QLS subscores (evaluation of health, marriage and partnership and sexuality) in patients with CIS compared to controls (p ≤ 0.048). Patients with CIS had higher BDI and BAI scores compared to controls (p ≤ 0.026). We also found negative correlation between scores for BDI, BAI and MSNQ, total QLS score and the specific QLS subscores in patients with CIS (r_sp ≤ –0.260; p ≤ 0.045). EDSS was negatively correlated with QLS subscore “evaluation of work and employment” (r_sp = –0.267; p = 0.041).

Conclusions:
In this study, we found lower life satisfaction in patients with CIS who are at high risk of developing multiple sclerosis. Lower life satisfaction in patients with CIS was more strongly associated with severity of depressive and anxiety symptoms and cognitive difficulties than with severity of disability.

Key words:
multiple sclerosis – clinically isolated syndrome – life satisfaction – anxiety – depression – cognitive difficulties – disability

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Chinese summary - 摘要

临床孤立综合征患者的生活满意度评估

目的：

我们的目标是评估临床孤立综合征（CIS）患者的生活满意度及其与抑郁、焦虑、认知障碍和残疾严重程度的相关性。

主题和方法：

研究对象包括60名CIS患者和42名健康志愿者，我们使用生活满意度问卷（QLS）评估其生活满意度，使用多发性硬化症神经心理学筛查问卷（MSNQ）评估其认知障碍，贝克抑郁量表（BDI）和贝克焦虑量表（BAI）被用来评估抑郁和焦虑程度。扩展的残疾状态量表（EDSS）被用来评估CIS患者的残疾严重程度。

结果：

与对照组相比，CIS患者的QLS总体评分和部分QLS子项评分较低（健康状况，婚姻状况和合作关系以及性行为评估）（p≤0.048）；BDI和BAI评分较高（p≤0.026）。我们还发现CIS患者的BDI，BAI和MSNQ得分、QLS总体得分和部分具体QLS得分之间呈负相关（rsp≤-0.260;p≤0.045）。EDSS与QLS “工作和就业评估”子项目分数呈负相关（rsp = -0.267; p = 0.041）。

结论：

在这项研究中，我们发现具有发展为多发性硬化症高风险的CIS患者的生活满意度较低。与残疾严重程度相比，CIS患者较低的生活满意度与抑郁程度、焦虑症状和认知障碍相关性更强。

关键词：

多发性硬化症 - 临床孤立综合征 - 生活满意度 - 焦虑 - 抑郁 - 认知障碍 - 残疾

Sources

1. Havrdová E, et al. Roztroušená skleróza. Praha: Mladá fronta 2013.

2. Hynčicová E, Meluzínová E, Vyhnálek M, et al. Postižení kognitivních funkcí v časných fázích roztroušené sklerózy. Cesk Slov Neurol N 2013;76/ 109(6):690– 4.

3. Chiaravalloti ND, DeLuca J. Cognitive impairment in multiple sclerosis. Lancet Neurol 2008;7(12):1139– 51. doi: 10.1016/ S1474-4422(08)70259.

4. Benedict RH, Cookfair D, Gavett R, et al. Validity of the minimal assessment of cognitive function in multiple sclerosis (MACFIMS). J Int Neuropsychol Soc 2006;12(4):549– 58.

5. Boeschoten RE, Braamse AM, Beekman AT, et al. Prevalence of depression and anxiety in Multiple Sclerosis: A systematic review and meta-analysis. J Neurol Sci 2007;372:331– 41. doi: 10.1016/ j.jns.2016.11.067.

6. Siegert RJ, Abernethy DA. Depression in multiple sclerosis: a review. J Neurol Neurosurg Psychiatry 2005;76(4):469– 75. doi: 10.1136/ jnnp.2004.054635.

7. Di Legge S, Piattella MC, Pozzilli C, et al. Longitudinal evaluation of depression and anxiety in patients with clinically isolated syndrome at high risk of developing early multiple sclerosis. Mult Scler 2003;9(3):302– 6. doi: 10.1191/ 1352458503ms921oa.

8. Anhoque CF, Domingues SC, Carvalho T, et al. Anxiety and depressive symptoms in clinically isolated syndrome and multiple sclerosis. Arq Neuropsiquiatr 2011;69(6):882– 6.

9. Nourbakhsh B, Julian L, Waubant E. Fatigue and depression predict quality of life in patients with early multiple sclerosis: a longitudinal study. Eur J Neurol 2006;23(9):1482– 6. doi: 10.1111/ ene.13102.

10. Anhoque CF, Biccas-Neto L, Domingues SC, et al. Cognitive impairment is correlated with reduced quality of life in patients with clinically isolated syndrome. Arq Neuropsiquiatr 2013;71(2):74– 7.

11. Polman CH, Reingold SC, Banwell B, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 2011;69(2):292– 302. doi: 10.1002/ ana.22366.

12. Benedict RH, Munschauer F, Linn R, et al. Screening for multiple sclerosis cognitive impairment using a self-administered 15-item questionnaire. Mult Scler 2003;9(1):95– 101.

13. Beck AT, Beamesderfer A. Assessment of depression: the depression inventory. Mod Problem Pharmacopsychiatry 1974;7(0):151– 169.

14. Beck AT, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988;56(6):893– 7.

15. Coons SJ, Rao S, Keininger DL, et al. A comparative review of generic quality-of-life instruments. Pharmacoeconomics 2000;17(1):13– 35.

16. Fahrenberg J MM, Schumacher J, Brähler E. Dotazník životní spokojenosti. Praha: Testcentrum 2001.

17. Putzki N, Fischer J, Gottwald K, et al. Quality of life in 1000 patients with early relapsing-remitting multiple sclerosis. Eur J Neurol 2009;16(6):713– 20.

18. Morales-Gonzales JM, Benito-Leon J, Rivera-Navarro J, et al. A systematic approach to analyse health--related quality of life in multiple sclerosis: the GEDMA study. Mult Scler 2004;10(1):47– 54. doi: 10.1191/ 1352458504ms967oa.

19. Korostil M, Feinstein A. Anxiety disorders and their clinical correlates in multiple sclerosis patients. Mult Scler 2007;13(1):67– 72. doi: 10.1177/ 1352458506071161.

20. Possa MF, Minacapelli E, Canale S, et al. The first year after diagnosis: psychological impact on people with multiple sclerosis. Psychol Health Med 2017;1– 9. doi: 10.1080/ 13548506.2016.1274043.

21. Janssens AC, van Doorn PA, de Boer JB, et al. Impact of recently diagnosed multiple sclerosis on quality of life, anxiety, depression and distress of patients and partners. Acta Neurol Scand 2003;108(6):389– 95.

22. Chruzander C, Ytterberg C, Gottberg K, et al. A 10-year follow-up of a population-based study of people with multiple sclerosis in Stockholm, Sweden: changes in health-related quality of life and the value of different factors in predicting health-related quality of life. J Neurol Sci 2014;339(1– 2):57– 63. doi: 10.1016/ j.jns.2014.01.020.

23. Jones E, Pike J, Marshall T, et al. Quantifying the relationship between increased disability and health care resource utilization, quality of life, work productivity, health care costs in patients with multiple sclerosis in the US. BMC Health Serv Res 2016;16:294. doi: 10.1186/ s12913-016-1532-1.