Supervisors info:
Γουρνέλλης Ρωσσέτος, Αναπληρωτής Καθηγητής, Ιατρική,ΕΚΠΑ
Δουζένης Αθανάσιος, Καθηγητής, Ιατρική, ΕΚΠΑ
Μιχόπουλος Ιωάννης, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Summary:
Background: Multiple Sclerosis (MS) is by far the most frequent of the demyelinating diseases, and one of the commonest devastating maladies of the nervous system. MS is characterized by time and space disseminated lesions in the brain and spinal cord, and usually has a relapsing course, although there also progressive types of the disease. Psychiatric symptoms are a core component of the MS phenotype.
Objective: The aim of the present research was to investigate the relation between MS and depression, anxiety, suicidality, sleep disturbances and fatigue. Furthermore, we tried demonstrate the presence of any possible relation 1) between the aforementioned psychiatric conditions and 2) between the aforementioned psychiatric features and specific parameters of the disease (MS type, MS duration and disability level).
Methods: We investigated two groups of participants, the MS group consisting of 50 hospitalized subjects (22 men, 28 women), and the control group consisting of 50 subjects (22 men, 28 women) who did not suffer from MS. The two groups were matched for the age, the gender, the marital and the educational status. Both groups were free of other major pathological and neurological disease. Additionally the MS group reported no history of major psychiatric disorder before the onset of MS. For the measurement of depression and anxiety we delivered the Hospital Anxiety Depression Scale (HADS), for suicidality the Suicidal Behaviors Questionnaire- Revised (SBQ-R), for sleep disturbances the Athens Insomnia Scale (AIS), for fatigue the Fatigue Severity Scale (FSS). We also used the Kurtzke Expanded Disability Status Scale (EDSS) for the evaluation of the disability due to MS. Finally we used the Mini Mental State Examination (MMSE) in order to exclude subjects with significant cognitive decline (cutoff point < 24). Specific demographics were collected for the necessary correlations to be made.
Results: In the MS group depression was correlated positively with anxiety, sleep disturbances, fatigue, suicidality, incapacity and age. Anxiety was positively correlated with depression, sleep disturbances, fatigue and age. Sleep disturbances were positively correlated with depression, anxiety, fatigue and age. Fatigue was positively correlated with depression, anxiety, sleep disturbances, disability level and age. Suicidality was only positively correlated with depression and disability level. The level of disability was also positively correlated with MS duration. The progressive types of MS were stronger positively correlated with depression and fatigue than the relapsing- remitting type. Our survey showed no correlation between gender and the psychiatric parameters under investigation. The subjects with lower educational level scored higher in depression, suicidality and fatigue. As far as the occupational status is concerned, the MS subjects with no occupation scored higher in all scales. Finally the marital status did not correlate significantly with the investigated psychiatric parameters.
Conclusions: The present research tried to clarify the impact of specific psychiatric disturbances in Greek MS hospitalized population. We hope to contribute to the better understanding and management of this burden. Due to the complexity of the field and the lack of suchlike surveys in Greece, we further encourage Greek researchers to evaluate and test the impact of psychiatric disturbances in MS.
Keywords:
Multiple sclerosis, Depression, Anxiety, Insomnia, Fatigue, Suicidality, Incapacity, Disability level
