Little research has studied the relationship between self-concept and depressive and anxiety symptoms and quality of life (QoL) on Multiple Sclerosis (MS). Previous studies suggested that perceived health status and self-perception seems to be affected by disease duration.
In this study, we evaluate the impact of receiving a MS diagnosis on disease perception (expectation and knowledge), depression, anxiety, fatigue, and QoL; and how these measures interact.
Observational, cross-sectional, multicentre study, with two matched groups.
Patients up to 3 months from diagnosis date were included in Group 1 and patients with diagnosis established for 12 to 36 months were included in Group 2. A 19-item true/false questionnaire developed by the investigators was used to assess disease knowledge and expectations. The remaining outcomes were assessed though: Hospital Anxiety and Depression Scale (HADS); Fatigue Severity Scale (FSS); and EuroQoL five-dimensional instrument (EQ-5D), 3-level version.
We included 90 patients from six centres (38 in the Group 1), of which 80% had a good disease knowledge whereas only 48% reported positive expectations. No differences were found between groups in demographic and clinical data. There were also no differences in disease knowledge, disease expectations, HADS, FSS, and EQ-5D. We found an inverse correlation between disease knowledge and problems in self-care (p=0.018) and fatigue (p=0.032). Patients with worse expectations about the disease were more anxious (p=0.012 on HADS and p<0.001 on EQ-5D). They also reported more problems in mobility (p=0.002), self-care (p=0.005), usual activities (p=0.009), and pain (p=0.001), having a worse health status comparing the last 12 months to the best imaginable status (p<0.001).
Our study showed no association between disease duration and disease knowledge, disease expectations, depression levels, anxiety, fatigue, and perceived QoL. Patients with less disease knowledge reported more problems in self-care and higher fatigue scores. Patients with worse disease expectations were more anxious and reported a worse health status. Our findings suggest that more attention should be driven to perceived health status and to depressive and anxious symptoms in MS patients.