A Cross-Sectional Examination of the Associations Between Symptoms, Community Integration, and Mental Health in Multiple Sclerosis

Publication date: Available online 31 October 2015
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Anna L. Kratz, Dawn M. Ehde, Marisol A. Hanley, Mark P. Jensen, Travis L. Osborne, George H. Kraft
ObjectiveTo determine the frequency and severity of eight symptoms in persons with multiple sclerosis (MS) and to examine the association between these symptoms and community integration and mental health.DesignA cross-sectional survey that assessed eight symptoms (pain, fatigue, imbalance, numbness, weakness, shortness of breath, vision loss, and memory loss), disease progression (the self-report version of the Expanded Disability Status Scale; EDSS), community integration, and mental health.SettingCommunity.Participants180 adults with self-reported MS who responded to a mailed survey.InterventionsNot applicable.Main Outcome MeasuresThe presence and intensity of symptoms were measured with a symptoms checklist. Community integration was assessed with the Community Integration Questionnaire and mental health was measured by the Mental Health Index of the Short Form Health Survey-36.ResultsThe average number of symptoms reported was 5.07 (SD = 2.18). The most common symptoms - fatigue, weakness, and imbalance - were also rated as most severe. Not all symptoms were associated with level of disease progression or with MS subtype. Symptoms related to mobility were more likely to be associated with these variables. The eight symptoms as a whole accounted for significant amounts of variance (ranging from 13% to 21%) in measures of community integration and mental health, with specific symptoms made differential independent contributions to these measures.ConclusionsThis study demonstrates that most individuals with MS report a number of bothersome symptoms. Type of MS or level of progression does not tell the whole story regarding the impact of symptoms.



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