The role of clinical, demographic and psychological characteristics of people with multiple sclerosis in their physical health related quality of life

Multiple Sclerosis (MS) is a chronic demyelinating and neurodegenerative disease of the central nervous system, with a variety of symptoms and uncertain course. It affects multiple facets of everyday life and since it results to some degree of disability, MS may cause deterioration of quality of life, both in mental and physical health. In this study, we investigated the role of demographic, clinical and, mostly, personal and psychological factors related to physical health quality of life (PHQOL). Our sample consisted of 90 patients with definite MS and the instruments used were: MSQoL-54 for PHQOL, DSQ-88 and LSI for the assessment of defense styles and mechanisms, BDI-II for depression, STAI for anxiety, SOC-29 as a measure of sense of coherence and FES for family relations. Important personality factors affecting PHQOL were the maladaptive and the self-sacrificing defense styles, the defense mechanisms of displacement and reaction formation, sense of coherence, while from the family environment, conflict affected PHQOL negatively and expressiveness positively. However, in the regression analysis none of these factors were found to be important. Multiple regression analysis showed the major impact of depression in PHQOL (negative correlation. Moreover, the fact that a person receives disability allowance, the number of the children, disability status and the event of a relapse in the current year, were also important negative factors for PHQOL. After a step-wise analysis, in which BDI and employment status were excluded, the most important variables were EDSS, SOC and relapse during the past year. This study confirms the hypothesis that psychological parameters play an important role in PHQOL and highlights the importance of the assessment of every PwMS by mental health professionals, as a routine. Not only psychiatric symptoms but also psychological parameters should be searched out in order to determine in which way each individual adjusts to the illness, thus impacting his PHQOL. As a result, targeted interventions, in personal or group level, or even in the family may enhance their QOL.