Grief Versus Depression in Multiple Sclerosis Patients

Objective: Most patients who are severely ill experience grief when confronted with the losses and limitations imposed by their illness. Differentiating between grief and depression is very crucial to a patient who is severely ill because of different management strategies for each. Aim: To differentiate between grief and depression in patients with multiple sclerosis (MS) and to compare the two types of MS; Remitting Relapsing MS (RRMS) and progressive MS (PMS) as regards hopelessness, depression, and grief. Methods: It is a cross-sectional study of 54 MS Patients subdivided into two groups RRMS group included 19 patients, and PMS group included 35 patients diagnosed according to McDonald’s criteria. They were evaluated by mini-mental state examination (MMSE), Expanded disability status scale (EDSS), Beck Hopelessness Scale (BHS) and the Palliative Grief Depression Scale. Results: 15% of RRMS patients were suffering from depression compared to 21.6% of PMS patients with no statistically significant difference. There was a statistically significant difference between the two groups as regards BHS with a high level of hopelessness in PMS than in RRMS patients. A statistically significant difference was found between the two groups as regards the EDSS scores with more disability in PMS. Statistically significant positive correlations were found between depression and hopelessness; between depression and loss oriented grief (LOG) in both groups; and between depression and duration of illness in RRMS patients. A statistically significant negative correlation was found between total grief and duration of illness in PMS patients. There were no statistically significant differences between both groups as regards total grief, restoration oriented grief (ROG) and LOG. Conclusion: Differentiation between depression and grief is very crucial in severely ill patients with MS to avoid overmedications and missing cases with depression. So we recommend doing a routine screening for depression and grief for seriously ill patients.