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Riccitelli GC, Pacifico D, Manconi M, Sparasci D, Sacco R, Gobbi C, Zecca C. RELATIONSHIP BETWEEN COGNITIVE DISTURBANCES AND SLEEP DISORDERS IN MULTIPLE SCLEROSIS IS MODULATED BY PSYCHIATRIC SYMPTOMS. Mult Scler Relat Disord 2022; 64:103936. [DOI: 10.1016/j.msard.2022.103936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/27/2022] [Accepted: 06/03/2022] [Indexed: 11/29/2022]
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Zarotti N, Eccles F, Broyd A, Longinotti C, Mobley A, Simpson J. Third wave cognitive behavioural therapies for people with multiple sclerosis: a scoping review. Disabil Rehabil 2022; 45:1720-1735. [PMID: 35514235 DOI: 10.1080/09638288.2022.2069292] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE Multiple sclerosis (MS) is a chronic condition linked to a wide range of psychological difficulties. While traditional cognitive behavioural therapy has been studied extensively with people with MS, much less is known about more recent "third wave" approaches. METHODS A scoping review was carried out by performing a systematic search across MEDLINE Complete, PsycINFO, CINAHL, Academic Search Ultimate, and Cochrane Library up to January 2022. RESULTS From an initial return of 8306 citations, 35 studies were included, 20 of which were randomised controlled trials (RCTs). These showed that four third wave approaches have been investigated with people with MS to date: acceptance and commitment therapy (ACT), dialectical behaviour therapy (DBT), mindfulness-based stress reduction (MBSR), and mindfulness-based cognitive therapy (MBCT). MBSR and MBCT may be helpful to address a range of psychological difficulties up to three months post-intervention. However, MS-specific adaptations may be required, and more evidence is needed on longer-term effectiveness. Limited evidence is also available for DBT and ACT, but additional research is warranted before any recommendation can be made. CONCLUSIONS As third wave approaches keep being refined, further more rigorous investigations are needed to implement them to the benefit of people with MS. Implications for RehabilitationMultiple sclerosis is linked to a wide range of psychological difficulties in adults.Little is currently known on third wave psychotherapies for people with MS.Mindfulness-based stress reduction and mindfulness-based cognitive therapy may be helpful to address a wide range of difficulties in MS.Specific adaptations may be needed to deliver suitable therapies to people with MS.Additional research is warranted to build on preliminary findings for DBT and ACT.
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Affiliation(s)
- Nicolò Zarotti
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Fiona Eccles
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Annabel Broyd
- University College London Hospitals NHS Trust, London, UK
| | | | - Amanda Mobley
- Worcestershire Health and Care NHS Trust, Worcester, UK
| | - Jane Simpson
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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Abstract
OBJECTIVE To identify factors that influence the perception parents with multiple sclerosis have of their competence in parenting. METHOD/DESIGN Subjects were parents of a child with a maximum of 18 years of age recruited through a national multiple sclerosis organization's social media channels. Data on demographic and disease information, mood, coping, quality of life and perceived social support were collected using an anonymous online questionnaire. Univariate and multivariate analyses were performed to assess associations between these variables and subjects' perception of parenting sense of competence. RESULTS The sample consisted of 285 parents with multiple sclerosis, with a mean age of 41 years and a mean disease duration of 10.4 years. In the multivariate analysis, independent determinants of lower parenting sense of competence were anxiety (p = 0.012), depression (p = 0.001) and dysfunctional coping (p = 0.005). Problem-focused coping (p = 0.029) and higher physical and mental scores on the SF-12 (p = 0.006, p < 0.001, respectively) were related to a higher parenting sense of competence. Higher parent age correlated with a lower sense of parenting competence (p = 0.002). CONCLUSIONS The perception parents with multiple sclerosis have of their parenting competence was most strongly correlated with mood, coping strategies and health-related quality of life, factors that are potentially modifiable.
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Affiliation(s)
| | - Michela Ponzio
- Italian Multiple Sclerosis Society Research Foundation, Genoa, Italy
| | - Silvia Traversa
- Italian Multiple Sclerosis Society Research Foundation, Genoa, Italy
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Jougleux C, Hennion S, Outteryck O, Vermersch P, Zéphir H. Characterization of alexithymia in clinically isolated syndrome. Rev Neurol (Paris) 2021; 177:1145-1150. [PMID: 34187691 DOI: 10.1016/j.neurol.2021.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/19/2021] [Accepted: 01/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND In multiple sclerosis (MS), the prevalence of alexithymia, defined as an inability to identify and describe emotions, is close to 50% but the prevalence of this symptom in clinically isolated syndrome (CIS) is unknown. Characterizing alexithymia at an early stage of the disease can help to clarify psychobehavioural disturbances in CIS patients. METHODS Forty CIS patients, who fulfilled the MRI criteria for dissemination in space, were matched with 40 healthy subjects. They completed self-assessment scales for alexithymia, depression, anxiety, apathy and empathy. Cognitive functions were assessed using a battery of neuropsychological tests. RESULTS The mean delay (± standard deviation) between the occurrence of CIS and inclusion in the study was 3.9 (2.8) months. The frequency of alexithymia was higher in CIS patients than in controls, with a prevalence of 42% (P<0.0001). Alexithymia correlated with anxiety and depression but not with cognition. Alexithymia was dependent only on depression (P=0.003). CONCLUSION Alexithymia, characterized by difficulty identifying feelings, is present in patients in the early stage of MS, and seems to be strongly associated with depression. Difficulty in social interaction could be a risk of future affective disorders.
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Affiliation(s)
| | - S Hennion
- CHU de Lille, France; Centre de référence épilepsie des maladies rares de Lille, France
| | - O Outteryck
- CHU de Lille, France; CHU de Lille. U1171 Université de Lille, France
| | - P Vermersch
- CHU de Lille, France; Université de Lille, U1172, Lille, France
| | - H Zéphir
- CHU de Lille, France; Université de Lille, U1172, Lille, France
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Santangelo G, Corte MD, Sparaco M, Miele G, Garramone F, Cropano M, Esposito S, Lavorgna L, Gallo A, Tedeschi G, Bonavita S. Coping strategies in relapsing-remitting multiple sclerosis non-depressed patients and their associations with disease activity. Acta Neurol Belg 2021; 121:465-71. [PMID: 31571134 DOI: 10.1007/s13760-019-01212-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 09/19/2019] [Indexed: 10/25/2022]
Abstract
Few studies evaluated coping strategies in people with multiple sclerosis (pwMS) in relation to annualized relapse rate (ARR) and lesion load (LL). Overall, results might have been influenced by the inclusion of depressed patients. To investigate the coping strategies and their association to disease activity, we studied relapsing-remitting pwMS accurately selected to avoid the confounding effect of depression. Sixty-seven relapsing-remitting pwMS and 67 healthy subjects (HS) underwent to Coping Orientation to Problems Experienced (I-COPE) and Coping Inventory for Stressful Situation (CISS) and Beck Depression Inventory-II. Cognitive performances, ARR, physical disability and magnetic resonance imaging T2-LL were assessed for correlation with coping and depression scores. pwMS showed lower scores than HSs on social support and turning to religion subscales of I-COPE and on emotion dimension of CISS. In pwMS, higher ARR was related to higher positive attitude and lower score on the turning to religion subscale of I-COPE. The present study revealed a less employment of emotion-based coping strategies in pwMS. A scarce use of faith for support and a frequent adoption of a positive attitude were associated with an increase of MS activity in terms of ARR.
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Seyedoshohadaee M, Parnian S, Haghani H, Sargolzaei MS. The effect of life skills training on the coping of people with multiple sclerosis. Cent Eur J Nurs Midw 2021. [DOI: 10.15452/cejnm.2020.11.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Wilski M, Gabryelski J, Brola W, Tomasz T. Health-related quality of life in multiple sclerosis: Links to acceptance, coping strategies and disease severity. Disabil Health J 2019; 12:608-14. [DOI: 10.1016/j.dhjo.2019.06.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 06/04/2019] [Accepted: 06/06/2019] [Indexed: 12/30/2022]
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Holland DP, Schlüter DK, Young CA, Mills RJ, Rog DJ, Ford HL, Orchard K; TONiC study group. Use of coping strategies in multiple sclerosis: Association with demographic and disease-related characteristics ✰. Mult Scler Relat Disord 2019; 27:214-22. [PMID: 30412819 DOI: 10.1016/j.msard.2018.10.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 09/22/2018] [Accepted: 10/21/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Coping positively and negatively influences psychosocial and other outcomes in multiple sclerosis (MS), but there is conflicting evidence about the use of different coping strategies and their associations with demographic and disease characteristics. Our aims were to examine which coping strategies are used by a large sample of people with MS, then to identify any associations between demographic and disease related factors with use of individual coping strategies. METHODS Participants in the Trajectories of Outcomes in Neurological Conditions (TONiC) study completed the Coping Orientations to Problems Experienced (COPE60) questionnaire. Relationships between demographic and clinical characteristics and coping strategies were examined by multiple ordinal logistic regression to assess the effect of each potential predictor after adjustment for other possible covariates. RESULTS From 722 patients, the most commonly used strategy was Acceptance, followed by Active Coping, Planning and Positive Reinterpretation and Growth. All but two strategies showed significant associations with demographic and clinical characteristics. The most marked effects were found for Restraint, with people in employment 2.1 times as likely to utilise this strategy compared to those unemployed, and Seeking of Emotional Social Support and Focus on and Venting of Emotions, which were utilised twice as much by women compared to men. Behavioural and Mental Disengagement were highly associated with greater disability and not being in employment. CONCLUSION Clinicians should be aware of several disease and demographic characteristics that are associated with use of potentially maladaptive coping strategies.
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Dehghani A, Dehghan Nayeri N, Ebadi A. Features of Coping with Disease in Iranian Multiple Sclerosis Patients: a Qualitative Study. J Caring Sci 2018; 7:35-40. [PMID: 29637055 PMCID: PMC5889796 DOI: 10.15171/jcs.2018.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 11/28/2017] [Indexed: 02/03/2023] Open
Abstract
Introduction: Coping with disease is of the main
components improving the quality of life in multiple sclerosis patients.
Identifying the characteristics of this concept is based on the experiences of
patients. Using qualitative research is essential to improve the quality of
life. This study was conducted to explore the features of coping with the
disease in patients with multiple sclerosis.
Method: In this conventional
content analysis study, eleven multiple sclerosis patients from Iran MS Society
in Tehran (Iran) participated. Purposive sampling was used to select
participants. Data were gathered using semi structured interviews. To analyze
data, a conventional content analysis approach was used to identify meaning
units and to make codes and categories.
Results: Results showed that features
of coping with disease in multiple sclerosis patients consists of (a) accepting
the current situation, (b) maintenance and development of human interactions,
(c) self-regulation and (d) self-efficacy. Each of these categories is composed
of sub-categories and codes that showed the perception and experience of
patients about the coping with disease.
Conclusion: Accordingly, a unique set of features regarding
features of coping with the disease were identified among the patients with
multiple sclerosis. Therefore, working to ensure the emergence of, and
subsequent reinforcement of these features in MS patients can be an important
step in improving the adjustment and quality of their lives.
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Affiliation(s)
- Ali Dehghani
- Department of Nursing, Faculty of Nursing and Paramedical, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Nahid Dehghan Nayeri
- Department of Nursing, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Department of Nursing, Behavioral Sciences Research Center, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Dehghani A, Keshavarzi A, Jahromi MF, Shahsavari isfahani S, Keshavarzi S. Concept analysis of coping with multiple sclerosis. Int J Nurs Sci 2018; 5:168-173. [PMID: 31406820 PMCID: PMC6626294 DOI: 10.1016/j.ijnss.2018.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 11/21/2017] [Accepted: 04/09/2018] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE The concept of coping with disease appears frequently in the literature; however, there is no precise definition of coping. The aim of this study is to clarify coping concept, and to identify its attributes, antecedents, and consequences in patients with multiple sclerosis. METHODS Rodgers' evolutionary method of concept analysis was used to clarify the concept of coping. A literature review was conducted with key terms 'multiple sclerosis', 'coping', 'adjustment', and 'deal with'. After searching databases, 1370 papers were found for the period 1995-2017. Finally, 55 articles and texts were selected for analysis. Data analysis was carried out using thematic analysis. An independent researcher checked the process to ensure credibility and reduce personal bias. RESULTS Coping with multiple sclerosis is a multidimensional concept with three main attributes: maintenance of emotional balance, acceptance of the disease, and self-regulation. Social support, awareness toward the disease, attitude toward the disease, and religious-spiritual beliefs were found as antecedents. Health promotion, adherence to treatment regimen, independence in personal life and social relationships, and improvement of family relationships were found as consequences of these attributes. CONCLUSION These findings not only add to the body of knowledge in health science, but also serve as an important motivation for further theory development and research in this context. Nurses and health professions can also benefit from a deeper understanding of coping concept in providing and planning healthcare for these patients.
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Affiliation(s)
- Ali Dehghani
- School of Nursing and Paramedical, Jahrom University of Medical Science, Jahrom, Iran
- Research Center for Noncommunicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Abdolkhalegh Keshavarzi
- Department of General Surgery, School of Medicine, Member of Shiraz Burn Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Soheila Keshavarzi
- Department of Counseling, Faculty of Psychology and Educational Sciences, Islamic Azad University, Marvdasht Branch, Marvdasht, Iran
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Brands I, Bol Y, Stapert S, Köhler S, van Heugten C. Is the effect of coping styles disease specific? Relationships with emotional distress and quality of life in acquired brain injury and multiple sclerosis. Clin Rehabil 2017; 32:116-126. [PMID: 28691532 DOI: 10.1177/0269215517718367] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To investigate the use of coping styles and the relationships linking coping to emotional distress and quality of life in patients with acquired brain injury and multiple sclerosis. METHOD Cross-sectional cohort study of 143 patients with acquired brain injury and 310 patients with multiple sclerosis in the chronic stage. Quality of life was measured with the Life Satisfaction Questionnaire (LiSat-9), coping styles with the Coping Inventory for Stressful Situations (CISS-T, task-oriented; CISS-E, emotion-oriented; CISS-A, avoidance), emotional distress with the Hospital Anxiety and Depression Scale (HADS). RESULTS Coping styles did not differ between types of multiple sclerosis and varied only little with regard to severity of disease. In both patient groups, task-oriented coping was most used followed by avoidance and emotion-oriented coping. Patients with multiple sclerosis used all styles to a greater extent. In acquired brain injury, lower CISS-E and lower HADS scores were associated with higher LiSat-9 scores. CISS-E had a direct effect on LiSat-9 and an indirect effect via HADS. In multiple sclerosis, next to lower CISS-E and lower HADS scores, higher CISS-A scores were also associated with higher LiSat-9 scores. CISS-E had an indirect effect and CISS-A had a direct and indirect effect on LiSat-9. CONCLUSION In both patient groups, coping patterns are similar, and emotion-oriented coping negatively influences quality of life. Additionally, in multiple sclerosis, seeking emotional support and distraction (CISS-A) was positively associated with quality of life. Interventions to improve adaptive coping could be organized within a neurorehabilitation setting for both patient groups together.
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Affiliation(s)
- Ingrid Brands
- 1 Department of Neurorehabilitation, Libra Rehabilitation Medicine and Audiology, Eindhoven, The Netherlands
| | - Yvonne Bol
- 2 Department of Clinical and Medical Psychology, Academic MS Center Limburg, Zuyderland Medical Center, Sittard-Geleen, The Netherlands
| | - Sven Stapert
- 2 Department of Clinical and Medical Psychology, Academic MS Center Limburg, Zuyderland Medical Center, Sittard-Geleen, The Netherlands.,3 Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- 4 School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Caroline van Heugten
- 3 Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.,4 School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Rolf L, Muris AH, Bol Y, Damoiseaux J, Smolders J, Hupperts R. Vitamin D 3 supplementation in multiple sclerosis: Symptoms and biomarkers of depression. J Neurol Sci 2017; 378:30-35. [DOI: 10.1016/j.jns.2017.04.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 03/10/2017] [Accepted: 04/04/2017] [Indexed: 02/06/2023]
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Calandri E, Graziano F, Borghi M, Bonino S. Coping strategies and adjustment to multiple sclerosis among recently diagnosed patients: the mediating role of sense of coherence. Clin Rehabil 2017; 31:1386-1395. [DOI: 10.1177/0269215517695374] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective: To examine the relationship between coping strategies (problem solving, emotional release, and avoidance) and adjustment (health-related quality of life, depression, and affective well-being) in a group of recently diagnosed multiple sclerosis patients (up to three years since diagnosis), and to explore the mediating role of sense of coherence between coping strategies and adjustment. Design: Cross-sectional. Setting: Multiple Sclerosis Clinic Centre. Subjects: A total of 102 patients (61.8% women; age (years): M = 35.8, SD = 11.9; 95% with a relapsing–remitting form of multiple sclerosis; Expanded Disability Status Scale score, between 1 and 4). Interventions: Not applicable. Main measures: Coping with multiple sclerosis (problem solving, emotional release, and avoidance), sense of coherence, health-related quality of life (SF-12), depression (CES-D), and affective well-being (PANAS). Results: Problem solving was linked to higher mental health ( β = 0.28) and higher affective well-being ( β = 0.36), emotional release was related to lower depression ( β = −0.22); avoidance was associated to higher mental health ( β = 0.25), higher affective well-being ( β = 0.24), and lower depression ( β = −0.29 ) (all betas were significant at p < 0.05). Sense of coherence mediated the relationship between emotional release and depression (Sobel z-value = −2.00; p < 0.05) and the relationship between avoidance and all the indicators of adjustment (mental health: Sobel z-value = 1.97; depression: Sobel z-value = −2.02; affective well-being: Sobel z-value= 2.05; p < 0.05). Conclusions: Emotional and avoidant coping strategies seem to be adaptive among recently diagnosed multiple sclerosis patients. A mediating role between coping strategies and adjustment is played by sense of coherence.
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Affiliation(s)
| | | | - Martina Borghi
- Cosso Foundation, Torino, Italy
- Neurology 2 – CRESM, San Luigi Gonzaga Hospital, Torino, Italy
| | - Silvia Bonino
- Department of Psychology, University of Torino, Torino, Italy
- Cosso Foundation, Torino, Italy
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Santangelo G, Sacco R, Siciliano M, Bisecco A, Muzzo G, Docimo R, De Stefano M, Bonavita S, Lavorgna L, Tedeschi G, Trojano L, Gallo A. Anxiety in Multiple Sclerosis: psychometric properties of the State-Trait Anxiety Inventory. Acta Neurol Scand 2016; 134:458-466. [PMID: 27219913 DOI: 10.1111/ane.12564] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The aims of the present study were to examine psychometric properties of the Spielberger State-Trait Anxiety Inventory (STAI-Y-1 and STAI-Y-2, respectively) in a Multiple Sclerosis (MS) population and to identify a cut-off score to detect those MS patients with high level of state and/or trait anxiety who could be more vulnerable to development of depression and/or cognitive defects. MATERIAL AND METHODS The STAI-Y-1 and STAI-Y-2 was completed by a group of patients (n = 175) affected by MS and a group of healthy subjects (n = 150) matched for age, educational level, and gender. In MS patients internal consistency, divergent and discriminant validities were evaluated. Construct validity was examined by exploratory factor analysis for each scale. RESULTS There was no missing data, no floor or ceiling effects for both scales. The two scales showed high internal consistency, good divergent, and Known-groups validities. To identify high levels of state and trait anxiety in a patient with MS, we proposed three gender specific screening cut-off values (1, 1.5, 2 SD) for the STAI-Y-1 and the STAI-Y-2. CONCLUSIONS The findings showed that the STAI-Y-1 and the STAI-Y-2 are a valid tool for clinical use in MS patients and can be useful to measure the severity of anxiety and to identify those patients with high anxiety to introduce them in specific non-pharmacological intervention.
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Affiliation(s)
- G. Santangelo
- Department of Psychology; Second University of Naples; Caserta Italy
- IDC-Hermitage-Capodimonte; Naples Italy
| | - R. Sacco
- MS Center; I Division of Neurology; Dept of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - M. Siciliano
- Department of Psychology; Second University of Naples; Caserta Italy
| | - A. Bisecco
- MS Center; I Division of Neurology; Dept of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - G. Muzzo
- MS Center; I Division of Neurology; Dept of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - R. Docimo
- MS Center; I Division of Neurology; Dept of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - M. De Stefano
- MS Center; I Division of Neurology; Dept of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - S. Bonavita
- MS Center; I Division of Neurology; Dept of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - L. Lavorgna
- MS Center; I Division of Neurology; Dept of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - G. Tedeschi
- IDC-Hermitage-Capodimonte; Naples Italy
- MS Center; I Division of Neurology; Dept of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - L. Trojano
- Department of Psychology; Second University of Naples; Caserta Italy
- Salvatore Maugeri Foundation; Scientific Institute of Telese; Telese Terme Italy
| | - A. Gallo
- MS Center; I Division of Neurology; Dept of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
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Vitkova M, Rosenberger J, Gdovinova Z, Szilasiova J, Mikula P, Groothoff JW, Reijneveld SA, van Dijk JP. Poor sleep quality in patients with multiple sclerosis: gender differences. Brain Behav 2016; 6:e00553. [PMID: 27843703 PMCID: PMC5102648 DOI: 10.1002/brb3.553] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 06/25/2016] [Accepted: 07/26/2016] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Most of the psychological and physical factors associated with poor sleep quality in patients with multiple sclerosis (MS) have a different prevalence in women and men, but whether or not these factors contribute differently to sleep quality in women and men with MS remains unclear. The aim of this study was to identify possible gender differences in factors related to poor sleep quality in MS patients. MATERIAL AND METHODS We collected data from 153 patients with MS. Patients filled out the Pittsburgh Sleep Quality Index (PSQI), the Hospital Anxiety and Depression Scale, and one item of the Short Form-36 regarding pain. RESULTS The best model of predictors of poor sleep quality consisting of gender, depression, anxiety, pain, and the interaction between gender and pain showed that the only variable interacting with gender, which was significantly associated with poor sleep quality was pain (odds ratio [OR] for interaction of pain with male gender was 15.4, 95% CI: 2.4; 39.5). Separate models for men and women consisting of pain, depression, anxiety, after adjustment for age, disease duration, and disability showed that pain was the only variable associated with poor sleep quality in men (OR = 12.7, 95% CI: 1.9; 29.6), whereas depression (OR = 4.1, 95% CI: 1.3; 13.2) and anxiety (OR = 6.8, 95% CI: 2.4; 19.1) were in women. CONCLUSIONS Factors contributing to poor sleep quality in MS patients differ by gender. Depression and anxiety are associated with poor sleep quality in women, whereas pain is in men. This highlights the need to apply gender-specific approaches to the treatment of sleep disorders.
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Affiliation(s)
- Marianna Vitkova
- Department of Neurology Faculty of Medicine Safarik University Kosice Slovakia; Graduate School Kosice Institute for Society and Health Safarik University Kosice Slovakia
| | - Jaroslav Rosenberger
- Graduate School Kosice Institute for Society and Health Safarik University Kosice Slovakia
| | - Zuzana Gdovinova
- Department of Neurology Faculty of Medicine Safarik University Kosice Slovakia
| | - Jarmila Szilasiova
- Department of Neurology Faculty of Medicine Safarik University Kosice Slovakia
| | - Pavol Mikula
- Graduate School Kosice Institute for Society and Health Safarik University Kosice Slovakia
| | - Johan W Groothoff
- Department of Community & Occupational Health University of Groningen University Medical Center Groningen Groningen the Netherlands
| | - Sijmen A Reijneveld
- Department of Community & Occupational Health University of Groningen University Medical Center Groningen Groningen the Netherlands
| | - Jitse P van Dijk
- Graduate School Kosice Institute for Society and Health Safarik University Kosice Slovakia; Department of Community & Occupational Health University of Groningen University Medical Center Groningen Groningen the Netherlands
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Abstract
Depression--be it a formal diagnosis based on consensus clinical criteria, or a collection of symptoms revealed by a self-report rating scale--is common in patients with multiple sclerosis (MS) and adds substantially to the morbidity and mortality associated with this disease. This Review discusses the prevalence and epidemiology of depression in patients with MS, before covering aetiological factors, including genetics, brain pathology, immunological changes, dysregulation of the hypothalamic-pituitary-adrenal axis, and psychosocial influences. Treatment options such as antidepressant drugs, cognitive-behavioural therapy, mindfulness-based therapy, exercise and electroconvulsive therapy are also reviewed in the context of MS-related depression. Frequent comorbid conditions, namely pain, fatigue, anxiety, cognitive dysfunction and alcohol use, are also summarized. The article then explores three key challenges facing researchers and clinicians: what is the optimal way to define depression in the context of diseases such as MS, in which the psychiatric and neurological symptoms overlap; how can current knowledge about the biological and psychological underpinnings of MS-related depression be used to boost the validity of this construct; and can intervention be made more effective through use of combination therapies with additive or synergistic effects, which might exceed the modest benefits derived from their individual components?
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