Author Of 3 Presentations
P1089 - Depressive Symptoms and Suicidal Ideation in Progressive Multiple Sclerosis Compared to Relapsing-Remitting Multiple Sclerosis (ID 1492)
Abstract
Background
Depression is one of the most common and impactful symptoms experienced by people with multiple sclerosis (MS). Most participants in prior studies of depression in MS had relapsing-remitting MS (RRMS), the most common MS subtype. Consequently, little is known about whether persons with progressive forms of MS have unique rehabilitation needs, such as higher risk for depression or suicidal ideation (SI), compared to persons with RRMS.
Objectives
To (1) describe depressive symptom severity and SI in persons with progressive MS; (2) compare depressive symptom severity and SI in persons with progressive MS and persons with RRMS; and (3) identify common and unique risk factors for greater depressive symptom severity and SI risk in persons with progressive MS compared to individuals with RRMS.
Methods
Adults with MS (N = 573) completed an observational survey study on quality of life in people with physical disabilities, including but not limited to MS. The dependent variables were depression symptoms and any SI as measured by the Patient Health Questionnaire-9. Comparisons between groups used t-test and chi-square analyses, and risk factors were tested by examining the interaction of MS subtype (progressive MS and RRMS) and each risk factor in multiple regression models with bootstrapping. Risk factors for greater depression severity and SI risk included age, race, gender, education level, marital status, employment status, household income, age at MS diagnosis, disease duration, disability level, problems with speech and/or swallowing, and current smoking status.
Results
Persons with progressive MS did not differ from persons with RRMS in levels of depressive symptoms or SI. Both groups reported mild depression symptoms and approximately 10% endorsed SI. Common risk factors for greater depressive symptom severity were younger age, greater disability, greater speech and swallowing problems, and lower household income (p’s<.05). Common risk factors for SI were shorter disease duration, greater disability, and greater speech and swallowing problems (p’s<.05). For persons with progressive MS, shorter disease duration and being non-White were associated with greater depressive symptom severity, and being employed was associated with SI risk (p’s<.05).
Conclusions
In this sample, there were no group differences between persons with progressive MS and persons with RRMS in depressive symptom severity and SI, though shorter disease duration, identifying as a racial minority, and being employed were unique risk factors for depression outcomes in persons with progressive MS. Consistent with current treatment guidelines for MS care, these findings underscore the importance of screening for and treating depressive disorders in all persons with MS, with particular attention to the factors that place some individuals with progressive MS at greater risk for both depression and SI, whether common or unique to their course.
P1090 - Differences in correlates of fatigue between relapsing and progressive forms of multiple sclerosis (ID 1564)
Abstract
Background
Fatigue is one of the most prevalent and impactful symptoms for people with multiple sclerosis (MS). MS fatigue can have detrimental effects on activities of daily living, employment, and quality of life. An inadequate number of studies have explored the extent to which fatigue and fatigue-related outcomes differ by MS disease course.
Objectives
To compare fatigue severity and fatigue interference, as well as identify common and unique demographic and clinical risk factors for fatigue severity and fatigue interference in persons with progressive MS compared to individuals with RRMS.
Methods
Participants were 573 community dwelling individuals with MS. The main outcome measures were fatigue severity and fatigue interference. T-test and chi-square analyses were used to compare group differences and multiple regression analyses were used to examine the extent to which the association of risk factors with fatigue severity and interference are moderated by MS subtype.
Results
There were no group differences between persons with progressive MS and RRMS in average fatigue severity or fatigue interference. Results also revealed there were no common risk factors between persons with progressive MS and RRMS. Longer MS disease duration was associated with lower average fatigue severity [b = -0.082, t(529) = -3.637, p < .001] for persons with progressive MS compared to persons with RRMS [b = -0.025, t(529) = -1.900, p = .058]. Having a college degree or higher was associated with higher fatigue interference in persons with progressive MS [b = 2.90, t(520) =2.28, p = .023] compared to persons with RRMS [b =-0.17, t(520) = -0.22, p = .825].
Conclusions
Contrary to previous research, in this sample, there were no group differences between persons with progressive MS and RRMS in average fatigue severity or fatigue interference. Given the similarity between fatigue and its correlates for both progressive and relapsing forms of MS, future research should consider if the interventions that work for fatigue management in people with relapsing forms of MS work similarly for people with progressive forms of MS.
P1103 - Moderators of improvements in fatigue impact following a self-management intervention in multiple sclerosis (ID 835)
Abstract
Background
Fatigue is one of the most common and disabling symptoms of multiple sclerosis (MS). A recent randomized controlled trial (RCT) showed a self-management program for fatigue and a general MS education program that controlled for time and attention had equivalent effects on reducing fatigue impact in adults with MS.
Objectives
Examine moderators of treatment-related improvements in fatigue impact following self-management and education interventions in adults with MS.
Methods
Secondary analysis of a recent RCT (N=218) using multilevel modeling to assess moderators of treatment improvements in fatigue impact through six-month follow-up. Hypothesized moderators included age, gender, cohabitation with or without a spouse/partner, MS subtype (relapsing-remitting MS or progressive MS) as well as baseline depression symptoms, sleep disturbance, and self-efficacy.
Results
Living with or without a spouse/partner moderated intervention effects on fatigue impact through the six-month follow-up (b = -0.23, t(588) = 2.09, p = .04; controlling for MS subtype and income). The findings suggested that, in the fatigue self-management group, participants living with a spouse/partner showed greater improvement in fatigue impact (within group Cohen’s d = 0.55) compared to participants who did not live with a spouse/partner (d = 0.14). However, in the general MS education group, improvements in fatigue impact were similar between participants living with a spouse/partner (d = 0.23) and those who did not live with a spouse/partner (d = 0.50). Age, gender, MS subtype and baseline depression symptoms, sleep disturbance, and self-efficacy did not moderate treatment effects on fatigue impact.
Conclusions
Although the findings are exploratory, this study emphasizes that the presence of a close relationship may facilitate benefit from self-management interventions for MS-related fatigue. Future research should investigate how to promote engaging supportive others in self-management interventions for MS-related fatigue.
Presenter Of 2 Presentations
P1089 - Depressive Symptoms and Suicidal Ideation in Progressive Multiple Sclerosis Compared to Relapsing-Remitting Multiple Sclerosis (ID 1492)
Abstract
Background
Depression is one of the most common and impactful symptoms experienced by people with multiple sclerosis (MS). Most participants in prior studies of depression in MS had relapsing-remitting MS (RRMS), the most common MS subtype. Consequently, little is known about whether persons with progressive forms of MS have unique rehabilitation needs, such as higher risk for depression or suicidal ideation (SI), compared to persons with RRMS.
Objectives
To (1) describe depressive symptom severity and SI in persons with progressive MS; (2) compare depressive symptom severity and SI in persons with progressive MS and persons with RRMS; and (3) identify common and unique risk factors for greater depressive symptom severity and SI risk in persons with progressive MS compared to individuals with RRMS.
Methods
Adults with MS (N = 573) completed an observational survey study on quality of life in people with physical disabilities, including but not limited to MS. The dependent variables were depression symptoms and any SI as measured by the Patient Health Questionnaire-9. Comparisons between groups used t-test and chi-square analyses, and risk factors were tested by examining the interaction of MS subtype (progressive MS and RRMS) and each risk factor in multiple regression models with bootstrapping. Risk factors for greater depression severity and SI risk included age, race, gender, education level, marital status, employment status, household income, age at MS diagnosis, disease duration, disability level, problems with speech and/or swallowing, and current smoking status.
Results
Persons with progressive MS did not differ from persons with RRMS in levels of depressive symptoms or SI. Both groups reported mild depression symptoms and approximately 10% endorsed SI. Common risk factors for greater depressive symptom severity were younger age, greater disability, greater speech and swallowing problems, and lower household income (p’s<.05). Common risk factors for SI were shorter disease duration, greater disability, and greater speech and swallowing problems (p’s<.05). For persons with progressive MS, shorter disease duration and being non-White were associated with greater depressive symptom severity, and being employed was associated with SI risk (p’s<.05).
Conclusions
In this sample, there were no group differences between persons with progressive MS and persons with RRMS in depressive symptom severity and SI, though shorter disease duration, identifying as a racial minority, and being employed were unique risk factors for depression outcomes in persons with progressive MS. Consistent with current treatment guidelines for MS care, these findings underscore the importance of screening for and treating depressive disorders in all persons with MS, with particular attention to the factors that place some individuals with progressive MS at greater risk for both depression and SI, whether common or unique to their course.
P1103 - Moderators of improvements in fatigue impact following a self-management intervention in multiple sclerosis (ID 835)
Abstract
Background
Fatigue is one of the most common and disabling symptoms of multiple sclerosis (MS). A recent randomized controlled trial (RCT) showed a self-management program for fatigue and a general MS education program that controlled for time and attention had equivalent effects on reducing fatigue impact in adults with MS.
Objectives
Examine moderators of treatment-related improvements in fatigue impact following self-management and education interventions in adults with MS.
Methods
Secondary analysis of a recent RCT (N=218) using multilevel modeling to assess moderators of treatment improvements in fatigue impact through six-month follow-up. Hypothesized moderators included age, gender, cohabitation with or without a spouse/partner, MS subtype (relapsing-remitting MS or progressive MS) as well as baseline depression symptoms, sleep disturbance, and self-efficacy.
Results
Living with or without a spouse/partner moderated intervention effects on fatigue impact through the six-month follow-up (b = -0.23, t(588) = 2.09, p = .04; controlling for MS subtype and income). The findings suggested that, in the fatigue self-management group, participants living with a spouse/partner showed greater improvement in fatigue impact (within group Cohen’s d = 0.55) compared to participants who did not live with a spouse/partner (d = 0.14). However, in the general MS education group, improvements in fatigue impact were similar between participants living with a spouse/partner (d = 0.23) and those who did not live with a spouse/partner (d = 0.50). Age, gender, MS subtype and baseline depression symptoms, sleep disturbance, and self-efficacy did not moderate treatment effects on fatigue impact.
Conclusions
Although the findings are exploratory, this study emphasizes that the presence of a close relationship may facilitate benefit from self-management interventions for MS-related fatigue. Future research should investigate how to promote engaging supportive others in self-management interventions for MS-related fatigue.