Author Of 2 Presentations
LB1158 - COVID-19 pandemic and mental distress in Multiple Sclerosis: implications for clinical management (ID 1300)
in multiple sclerosis (MS), disease-related factors and dysfunctional coping might favour the development of mental distress induced by COVID-19 containment measures.
to explore the relationship between mental distress, disability and coping strategies in the Italian MS population under lockdown.
Structural equation modeling (SEM) was applied to information collected via web-survey to identify modifiable factors that could account for mental distress. Information about the following domains was collected: (1) socio-demographic features; (2) general and MS related health status; (3) changes in lifestyle; (4) COVID-19 infection and risk perception; (5) physical disability assessed via the Patient-Determined Disease Steps (PDDS) scale and the Upper Extremity Function – Short Form (UEF) from the Quality of Life in Neurological Disorders (Neuro-QoL) measurement system; (6) cognitive function investigated using the Cognition Function– Short Form from the Neuro-QoL. Abstract reasoning, logical thinking and, in part, sustained attention, were measured using six Raven-like matrices; (7) mental distress: four domains from the Neuro-QoL were explored. Specifically, sleep disturbances, anxiety feelings, depressive symptoms, emotional dyscontrol; (8) coping strategies: individual response to lockdown was assessed using 18 items from the COPE-NVI-25, evaluating five independent coping strategies: avoidance (AV), social support (SS), positive attitude (PA), problem solving (PS) and turning to religion (TR).
845 subjects (497 MS and 348 controls) were included in the study. MS patients showed higher scores than controls for depression (p=0.005), but not for anxiety, emotional dyscontrol or sleep disturbances. The SEM explained 74% of the variance observed in depression score. Within the model, three latent factors were characterized from measured variables: motor disability and cognitive dysfunction contributed to disability (β=0.509 and β=0.836, p<0.001); positive attitude and exercise contributed to active attitude (β=0.386 and β=0.297, p<0.001); avoidance, social support and watching TV contributed to passive attitude (β=0.301, β=0.243 and β=0.212, p<0.001). As per the relationship between latent factors and their influence on depression, disability contributed to passive attitude (β=0.855, p<0.001) while both passive and active attitude significantly influenced depression (β=0.729 and β=-0.456, p<0.001).
As practical implication of our model, favoring exercise would enhance active attitude and its positive impact on mental well-being while, at the same time, reducing the negative impact of disability on depression, representing a valuable tool for the long term management of COVID-19 related mental distress in MS.
LB1191 - Validation of the Italian version of the Multiple sclerosis intimacy and sexuality questionnaire-19 (ID 1991)
People with Multiple sclerosis (MS) may experience sexual dysfunction throughout the disease course. Prevalence for sexual dysfunction in MS ranges from 70 to 90 %, higher than in healthy controls (about 50%). Clinicians do not always ask for sexual dysfunction both for the limited timeframe for clinical assessment and the intimate nature of the subject. Hence, the use of self-reported questionnaires would be useful in clinical practice. However, validated scales to assess sexual dysfunction in MS for Italian patients are lacking.
We aimed at validating Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ-19) for Italian MS patients.
We included both male and female MS patients. Each patient completed the Italian translation of the MSISQ-19, the Beck Depression Inventory (BDI-II), the Modified Fatigue Impact Scale (MFIS), the State-Trait Anxiety Inventory (STAI-Y) questionnaire, the International Consultation on Incontinence Questionnaire Lower Urinary Tract Symptoms Quality of Life Module (ICIQ-LUTSqol), the Female Sexual Function Index (FSFI, for female) and the International Index of Erectile Function (IIEF for male). Construct validity for the Italian version of the MSISQ-19 was explored by the exploratory factor analysis and the Cronbach’s alpha coefficient. Test-retest stability and concurrent internal and external validity was examined by Pearson’ correlation coefficients.
We enrolled 369 MS patients (323 female). Mean MSISQ-19 total score was 37.2 ± 15.2 (range 18 - 89) with a sexual dysfunction prevalence of 59% in male MS patients and 41% in female MS patients. Cronbach’s alpha was 0.92 for the MSISQ-19. MSISQ-19 test and retest total scores correlated between each other (r=0.48, p=0.01). MSISQ-19 total score also correlated with primary, secondary and tertiary subscales (p<0.001), with the EDSS (r=0.19, p<0.001) and all other neuropsychological scales.
The Italian Version of the MSISQ-19 showed satisfactory internal consistency and reliability with moderately adequate test-retest reproducibility, suggesting that the Italian MSISQ-19 questionnaire provides a valuable measure of sexual dysfunction in the Italian population.