The relationship between psychopathology, psychosocial adjustment, social support and quality of life in multiple sclerosis

Yıl 2019, Cilt: 5 Sayı: 1, 20 - 28, 04.01.2019

Vahap Ozan Kotan , Zeynep Kotan , Birgül Aydın Özlem Taşkapılıoğlu Berna Alkan , Güven Özkaya , Aslı Sarandöl Ömer Faruk Turan Selçuk Kırlı

https://doi.org/10.18621/eurj.382894

Cited By: 4

Öz

Objectives: Multiple
Sclerosis (MS) is a chronic disease which affects physical,psychological and
social functioning of patients. In this study we aim to indicate psychiatric
comorbidity, some psychosocial factors and their associations with quality of
life in patients with MS.

Methods: A total of 227 patients
underwent psychiatric examination and the following scales were applied:
Socio-demographic data form, Hospital Anxiety and Depression Scale (HADS),
Multiple Sclerosis Quality of Life-54 (MSQOL-54), Psychosocial Adjustment to
Illness Scale-Self report (PAIS-SR) and Multidimensional Scale of Perceived
Social Support (MSPSS).

Results: Among 227 patients with MS,
67.8% (n = 154) had psychiatric diagnosis; 24.2% (n = 55) had depression,19.8%
(n = 45) had adjustment disorder, 14.9% (n = 34) had anxiety disorder, 7.1%
(n=16) had dysthymic disorder and 1.8% (n = 4) had bipolar disorder. Patients
with a psychiatric diagnosis had lower scores in role limitations due to
emotional problems, emotional well-being, health perceptions, social function,
cognitive function, health distress and mental health composite of MSQOL-54.
PAIS-SR and MSPSS scores were significantly lower in MS patients with a
psychiatric diagnosis. PAIS-SR scores were negatively
correlated with role limitations-emotional, emotional well-being, social
function, sexual function, satisfaction with sexual function, physical health
composite and mental health composite scores of MSQOL-54. MSPSS total score was
positively correlated with emotional well-being score of MSQOL-54.

Conclusions: In MS patients, there is a high prevalence of psychopathology and it is
associated with quality of life, perceived social support and psychosocial
adjustment of the patients. Quality of life is reduced especially in emotional
and mental aspects in patients with a psychiatric diagnosis. Diagnosis and
treatment of psychopathology in MS patients seems crucial to decrease disease
burden. 

Anahtar Kelimeler

Multiple sclerosis, psychopathology, psychosocial adjustment, socials upport, quality of life

Kaynakça

• [1] EbersGC. Environmental factors and multiple sclerosis. Lancet Neurol 2008;7:268-77.
• [2] Ghaffar O, Feinstein A. The neuro-psychiatry of multiple sclerosis: a review of recent developments. Curr Opin Psychiatry 2007;20:278-85.
• [3] Patten SB, Beck CA, Williams JV, Barbui C, Metz LM. Major depression in multiple sclerosis: a population-based perspective. Neurology 2003;61:1524-7.
• [4] Cummings JL, Arciniegas DB, Brooks BR, Herndon RM, Lauterbach EC, Pioro EP, et al. Defining and diagnosing involuntary emotional expression disorder. CNS Spectr 2006;11:1-7.
• [5] Gold SM, Irwin MR. Depression and immunity: inflammation and depressive symptoms in multiple sclerosis. Neurol Clin 2006;24:507-19.
• [6] Mohr DC, Classen C, Barrera M, Jr. The relationship between social support, depression and treatment for depression in people with multiple sclerosis. Psychol Med 2004;34:533-41.
• [7] Korostil M, Feinstein A. Anxiety disorders and their clinical correlates in multiple sclerosis patients. Mult Scler 2007;13:67-72.
• [8] Sanfilipo MP, Benedict RH, Weinstock-Guttman B, Bakshi R. Gray and white matter brain atrophy and neuropsychological impairment in multiple sclerosis. Neurology 2006;66:685-92.
• [9] Marks SF. Nursing assessment of positive adjustment for individuals with multiple sclerosis. Rehabil Nurs 1990;15:147-51.
• [10] Stanton AL, Collins CA, Sworowski LA. Adjustment to chronic illness: theory and research. In: Baum A, Revenson TA, Singer JE, eds. Handbook of health psychology. Mahwah, NJ: Erlbaum, 2001.,pp. 387-403.
• [11] Hirsch BJ. Natural support systems and coping with major life changes. Am J Comm Psychol 1980;8:159-72.
• [12] Reblin M, Uchino BN. Social and emotional support and its implication for health. Curr Opin Psychiatry 2008;21:201-5.
• [13] Sullivan CL, Wilken JA, Rabin BM, Demorest M, Bever C. Psychosocial adjustment to multiple sclerosis. Int J MS Care 2004;6:98-105.
• [14] Fekete EM, Antoni MH, Scheiderman N. Psychosocial and behavioral interventions for chronic medical conditions. Curr Opin Psychiatry 2007;20:152-7.
• [15] Kes VB, Cengić L, Cesarik M, Tomas AJ, Zavoreo I, Matovina LZ, et al. Quality of life in patients with multiple sclerosis. Acta Clin Croat 2013;52:107-11.
• [16] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. 4th ed., text rev. Washington DC: American Psychiatric Press, 2000.
• [17] Aydemir Ö. Validity and Reliability of Turkish Version of Hospital Anxiety and Depression Scale. Turk J Psychiatry 1997;8:280-7.
• [18] Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473-83.
• [19] Koçyiğit H, Aydemir Ö, Ölmez N. Reliability and Validity of SF-36 in Turkish. Med Treat J 1999;12:102-6.
• [20] Adaylar M. Kronik hastalığı olan bireylerin hastalıktaki tutum, adaptasyon, algı ve özbakım yönelimleri. DoktoraTezi, İstanbul: İstanbul Üniversitesi SağlıkBilimleriEnstitüsü, Hemşirelik Anabilim Dalı, 1995.
• [21] Derogatis LR. The psychosocial adjustment to illness scale (PAIS). J Psychosom Res 1986;30:77-91.
• [22] Tulek Z. Determination of Quality of Life in Multiple Sclerosis Patients Who Have Been Followed Regularly. Doctoral Thesis. Istanbul University, Institute of Health Sciences, Department of Nursing, Istanbul, 2006.
• [23] Jose Sa M. Psychological aspects of multiple sclerosis. Clin Neurol Neurosur 2008;110:868-77.
• [24] Feinstein A. Neuropsychiatric syndromes associated with multiple sclerosis. J Neurol 2007;254:73-6.
• [25] Wilken JA, Sullivan C. Recognizing and treating common psychiatric disorders in multiple sclerosis. Neurologist 2007;13:343-54.
• [26] Schiffer RB, Wineman NM, Weitkamp LR. Association between bipolar affective disorder and multiple sclerosis. Am J Psychiatry 1986;143:94-5.
• [27] Sidhom Y, Djebara MB, Hizem Y, Abdelkefi I, Kacem I, Gargouri A, et al. Bipolar disorder and multiple sclerosis: a case series. Behav Neurol 2014;2014:536503.
• [28] Galeazzi GM, Ferrari S, Giaroli G, Mackinnon A, Merelli E, Motti L, et al. Psychiatric disorders and depression in multiple sclerosis outpatients: impact of disability and interferon beta therapy. Neurol Sci 2005;26:255-62.
• [29] Compston A, Coles A. Multiple sclerosis. Lancet 2008;372:1502-17.
• [30] Mullins LL, Cote MP, Fuemmeler BF, Jean VM, Beatty WW, Paul RH. Illness intrusiveness, uncertainty and distress in individuals with multiple sclerosis. Rehabil Psychol 2001;46:139-53.
• [31] Kocaman N, Kutlu Y, Ozkan M, Ozkan S. Predictors of psychosocial adjustment in people with physical disease. J Clin Nurs 2007;16(3A):6-16.
• [32] Kotan VO, Kotan Z, Aydin B, Taskapilioglu O, Yalvac HD, Ozkaya G, et al. Psychopathology, psychosocial factors and quality of life in patients with myasthenia gravis. J Neurol Sci-Turk 2016;33:482-93.
• [33] de Ridder D, Geenen R, Kuijer R, van Middendorp H. Psychological adjustment to chronic disease. Lancet 2008;372:246-55.
• [34] Navarta-Sánchez MV, Senosiain-García JM, Riverol M, Ursúa Sesma ME, de Cerio Ayesa SD, Bravo SA, et al. Factors influencing psychosocial adjustment and quality of life in Parkinson patients and informal caregivers. Qual Life Res 2016;25:1959-68.
• [35] Hupcey JE. Clarifying the social support theory research linkage. J Adv Nurs 1998;27:1231-41.
• [36] Foote AW, Piazza D, Holcombe J, Paul P, Daffin P. Hope, self-esteem, and social support in persons with multiple sclerosis. J Neurosci Nurs 1990;22:155-9.
• [37] Miller CM. The lived experience of relapsing multiple sclerosis: A phenomenological study. J Neurosci Nurs 1997;29:291-304.
• [38] Yilmaz Ozpolat AG, Ayaz T, Konag O, Ozkan A. Attachment style and perceived social support as predictors of biopsychosocial adjustment to cancer. Turk J Med Sci 2014;44:24-30.
• [39] Staniute M, Brozaitiene J, Burkauskas J, Kazukauskiene N, Mickuviene N, Buneviciuset R. Type D personality, mental distress, social support and health-related quality of life in coronary artery disease patients with heart failure: a longitudinal observational study. Health Qual Life Outcomes 2015;13:1.
• [40] Cohen SD, Sharma T, Acquaviva K, Peterson RA, Patel SS, Kimmel PL. Social support and chronic kidney disease: an update. Adv Chronic Kidney Dis 2007;14:335-44.
• [41] Schwartz C, Frohner R. Contribution of demographic, medical, and social support variables in predicting the mental health dimension of quality of life among people with multiple sclerosis. Health Soc Work 2005;30:203-12.
• [42] Gulick EE. Social support among persons with multiple sclerosis. Res Nurs Health 1994;17:195-206.
• [43] Mitchell AJ, Benito-León J, González JM, Rivera-Navarro J. Quality of life and its assessment in multiple sclerosis: integrating physical and psychological components of wellbeing. Lancet Neurol 2005;4:556-66.
• [44] Lobentanz IS, Asenbaum S, Vass K, Sauter C, Klösch G, Kollegger H, et al. Factors influencing quality of life in multiple sclerosis patients: disability, depressive mood, fatigue and sleep quality. Acta Neurol Scand 2004;110:6-13.
• [45] Herschbach P, Keller M, Knight L, Brandl T, Huber B, Henrich G, et al. Psychological problems of cancer patients: a cancer distress screening with a cancer-specific questionnaire. Br J Cancer 2004;91:504-11.
• [46] Stenager E, Knudsen L, Jensen K. Multiple sclerosis: correlation of anxiety, physical impairment and cognitive dysfunction. Ital J Neurol Sci 1994;15:99-103.
• [47] Janssens ACJW, van Doorn PA, de Boer JB, Kalkers NF, van der Meché FGA, Passchier J, et al. Anxiety and depression influence the relation between disability status and quality of life in multiple sclerosis. Mult Scler 2003;9:397-403.