Mental Health Issues in Multiple Sclerosis Patients and Healthy Controls and Their Association with Disease Related Factors

Purpose: To investigate the mental health problems of multiple sclerosis (MS) patients, and the relationship between mental health, MS variables and disability status.

Methods: The sample consisted of 80 participants, 40 MS patients and 40 Healthy Controls matched for gender, age and socioeconomic status. There were 30 (75%) women and 10 (25%) men, 27 (67.5%) Relapsing Remitting Multiple Sclerosis (RRMS) patients, 8 (20%), Secondary Progressive (SP) patients and 5 (12.5%) Primary Progressive (PP) patients in the MS group, 26 (65%) of those were on systemic treatment. The General Health Questionnaire-28 (GHQ-28) was used to screen for mental health issues. Disability status was assessed with the Expanded Disability Status Scale (EDSS).

Mean comparisons were performed using Student’s t test while effect sizes were estimated by Cohen’s d coefficient. Percentage ratio differences were tested using chi-square tests, corrected by Fischer’s exact test for 1 df. Correlations were investigated using Pearson’s r coefficient.

Results: MS patients exhibited significantly more mental health problems than the healthy controls. The effect size of the presence of positive MS diagnosis ranged from large to very large with respect to overall psychological distress as well as with respect to the following different dimensions of psychological distress: somatic symptoms, anxiety - insomnia, social dysfunction and severe depression. There were significantly more MS patients who could be diagnosed with mental health disorders (non psychotic disorders of axis I, DSM-IV-TR). Finally, no aspects of mental health impairment were significantly correlated with disease variables or disability status.

Conclusions: Mental health problems in MS patients are evident and frequent. As they are independent of illness duration, medication or disability, special care should be taken in treating mental health problems in MS patients.