Coping and quality of life in one hundred and thirty five subjects with multiple sclerosis

Abstract

Introduction and objective The aim of this study was to compare coping strategies and quality of life (QoL) in multiple sclerosis (MS), as they relate to the course of the disease (relapsing-remitting (RR), secondary progressive (SP), primary progressive (PP)), while taking depression and anxiety into account. Methods A total of 135 MS subjects were seen for a semi-structured interview in order to collect socio-demographic and clinical information, after which there was an assessment of their mental and cognitive states (Mini International Neuropsychiatric Interview (MINI), Montgomery and Asberg Depression Rating Scale (MADRS), Depressive Mood Scale (EHD), Hamilton Anxiety (HAMA), Frontal Assessment Battery (FAB)). All subjects then completed three self-report questionnaires; two about coping strategies (Ways of Coping Checklist (WCC), Coping with Health, Injuries and Problems Scale (CHIP)) and one about QoL (SEP59). Results The mental health (depression and anxiety) and the psychological and social dimensions of QoL were relatively unaffected. However, after controlling for age and disability, the disease course had a strong effect on both mental health and QoL, with the poorest condition for SPMS and the best condition for PPMS. The SPMS patients tend to use emotional coping strategies extensively, while the PPMS patients use more instrumental strategies. Discussion Our study clearly demonstrated that psychological and social well-being were substantially affected by the disease course. These results encourage us to develop interventions focused on coping strategies and which are better adapted to individual patients. Multiple Sclerosis 2007; 13: 393- 401. http://msj.sagepub.com