Depression and psychological distress symptoms can have a huge effect on the way multiple sclerosis (MS) patients view their well-being, a new study has found.
Since depression and psychological distress symptoms can be targeted therapeutically, the study proposes focusing on mental health disorders in MS patients to considerably improve their quality of life.
The research article, “Determinants of quality of life in relapsing-remitting and progressive multiple sclerosis,” was published in the journal Multiple Sclerosis and Related Disorders.
MS can have a severe impact on patients’ quality of life, affecting their ability to participate in everyday routines. Patients who experience more physical disability usually report poorer quality of life. Quality of life also is negatively influenced by fatigue — the more physically exhausted the patient, the more quality of life diminishes.
Quality of life also has been shown to decrease with cognition impairment in MS patients, and has been associated with the patient’s level of cognitive reserve — the mind’s resistance to damage to the brain, and the ability to optimize or maximize the brain’s performance.
The co-occurrence of psychopathological disorders like depression exerts a negative influence on patients’ quality of life, too.
Understanding the different factors that affect patients’ quality of life is vital to improve MS treatment management. Plus, whether these factors differ across the different types of MS, including relapsing-remitting MS (RRMS), primary progressive MS (PPMS), and secondary progressive MS (SPMS), has not been thoroughly explored.
Now, researchers from the University Hospital Frankfurt, Germany, investigated further how these different factors affect MS patients’ quality of life. Specifically, the team looked at the effects of physical impairment, upper extremity function, cognitive impairment, cognitive reserve, depression, psychological distress symptoms, fatigue, as well as age and disease duration, on patient-reported measures of quality of life.
In total, 55 MS patients were analyzed — 39 RRMS and 16 progressive MS.
Results showed that MS patients with a university degree, RRMS instead of a progressive disease course, lower levels of depression and psychological distress symptoms, shorter disease duration, and reduced disease severity, had a significantly better quality of life.
No link was found between measures of quality of life and physical disability, or upper extremity disability, or cognitive impairment.
Although fatigue is known to be a major factor affecting patients’ subjective well-being, the researchers did not find an effect of fatigue on quality of life in MS patients.
Overall, the findings are in line with individual studies focusing on these factors separately.
The researchers noted that among these factors, depression and psychological distress symptoms can be treated. “Since they can be targeted by both psychopharmacological and psychotherapeutic treatment, focusing on mental comorbidity could substantially increase quality of life in MS,” the researchers wrote.
This is important because psychopathological disorders, although often co-occurring with MS, remain undiagnosed or undertreated. Furthermore, MS patients view their mental health disorders equally as important as their physical health, and frequently report a need for mental healthcare.
“The current results highlight the urgent need for early and effective symptomatic treatment of mental comorbidity” in MS patients, the research team concluded.
