Perception of prognostic risk in patients with multiple sclerosis: the relationship with anxiety, depression, and disease-related distress.

OBJECTIVE The aim of the study was to investigate the impact of perception of prognostic risk on anxiety, depression, and disease-related distress in patients with multiple sclerosis (MS). STUDY DESIGN AND SETTING Perceived risk and perceived seriousness of the 2-year, 10-year, and lifetime prognosis of wheelchair dependence, disability status, anxiety, depression, and disease-related distress were assessed in 101 patients. Distress was measured as the intrusion and avoidance of MS-related thoughts and feelings. RESULTS Patients with higher perceptions of 2-year, 10-year, or lifetime risk were bothered by more intrusion of MS-related thoughts and feelings. Only higher perception of the 2-year risk of wheelchair dependence was significantly related with higher levels of anxiety, depression, and avoidance. Similarly, higher perception of the seriousness of wheelchair dependence was consistently associated with more intrusion and avoidance, but only perceived seriousness of the 2-year prospect of wheelchair dependence was significantly correlated with anxiety and depression. All relations were independent of clinically assessed disability status. CONCLUSION Perceptions of the short-term risk and seriousness of wheelchair dependence were significantly related to anxiety, depression, and disease-related distress in patients with MS. These findings underscore the importance of informing patients with chronic disorders about the short-term prognosis of important long-term consequences of disease.

[1]  R. Steiner,et al.  A comparative analysis of coping behaviors in persons with multiple sclerosis or a spinal cord injury. , 1994, Research in nursing & health.

[2]  B Fischhoff,et al.  A New Scale for Assessing Perceptions of Chance , 2000, Medical decision making : an international journal of the Society for Medical Decision Making.

[3]  C. Carver,et al.  Optimism versus pessimism predicts the quality of women's adjustment to early stage breast cancer , 1994, Cancer.

[4]  J. Kurtzke.  Rating neurologic impairment in multiple sclerosis , 1983, Neurology.

[5]  D. Silberberg,et al.  New diagnostic criteria for multiple sclerosis: Guidelines for research protocols , 1983, Annals of neurology.

[6]  S. Lynch,et al.  The relationship between disability and depression in multiple sclerosis: the role of uncertainty, coping, and hope , 2001, Multiple sclerosis.

[7]  C. Steel,et al.  Cancer risk perceptions and distress among women attending a familial ovarian cancer clinic , 2001, British Journal of Cancer.

[8]  H. Grönberg,et al.  Risk perception, screening practice and interest in genetic testing among unaffected men in families with hereditary prostate cancer. , 2000, European journal of cancer.

[9]  K. Pakenham.  Adjustment to multiple sclerosis: application of a stress and coping model. , 1999, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[10]  M. Horowitz,et al.  Impact of Event Scale: psychometric properties. , 2002, The British journal of psychiatry : the journal of mental science.

[11]  M. Fournier,et al.  Optimism and Adaptation to Multiple Sclerosis: What Does Optimism Mean? , 1999, Journal of Behavioral Medicine.

[12]  B. Saletu,et al.  Depression and quality of life in multiple sclerosis , 2001, Acta neurologica Scandinavica.

[13]  S. Patten,et al.  Depression in multiple sclerosis. , 1997, Psychotherapy and psychosomatics.

[14]  B. Tabachnick,et al.  Using Multivariate Statistics , 1983 .

[15]  M. Hunter,et al.  Perception of future health risks in mid-aged women: estimates with and without behavioural changes and hormone replacement therapy. , 1999, Maturitas.

[16]  F. Mcdowell,et al.  PROBLEMS OF EXPERIMENTAL TRIALS OF THERAPY IN MULTIPLE SCLEROSIS: REPORT BY THE PANEL ON THE EVALUATION OF EXPERIMENTAL TRIALS OF THERAPY IN MULTIPLE SCLEROSIS , 1965, Annals of the New York Academy of Sciences.

[17]  F. Fazekas,et al.  Die Einstellung von Patienten mit multipler Sklerose zur Krankheitsaufklärung , 1997, Der Nervenarzt.

[18]  R. Amato,et al.  The association between treatment‐specific optimism and depressive symptomatology in patients enrolled in a Phase I cancer clinical trial , 2001, Cancer.

[19]  R. Zivadinov,et al.  Depression and anxiety in multiple sclerosis. A clinical and MRI study in 95 subjects , 2001, Journal of Neurology.

[20]  S. Lynch,et al.  Depression during exacerbations in multiple sclerosis: the importance of uncertainty , 2001, Multiple sclerosis.

[21]  V. Janardhan,et al.  Brain MRI lesions and atrophy are related to depression in multiple sclerosis , 2000, Neuroreport.

[22]  J. Klijn,et al.  Psychological impact of receiving a BRCA1/BRCA2 test result. , 2001, American journal of medical genetics.

[23]  C. Herrmann.  International experiences with the Hospital Anxiety and Depression Scale--a review of validation data and clinical results. , 1997, Journal of psychosomatic research.

[24]  J. Baskerville,et al.  The natural history of multiple sclerosis: a geographically based study. 5. The clinical features and natural history of primary progressive multiple sclerosis. , 1999, Brain : a journal of neurology.

[25]  R. Eeles,et al.  Familial breast cancer: a controlled study of risk perception, psychological morbidity and health beliefs in women attending for genetic counselling. , 1996, British Journal of Cancer.

[26]  H. Keen,et al.  More good than harm: a randomised controlled trial of the effect of education about familial risk of diabetes on psychological outcomes. , 2000, The British journal of general practice : the journal of the Royal College of General Practitioners.

[27]  Michael W. Bridges,et al.  Optimism and rehospitalization after coronary artery bypass graft surgery. , 1999, Archives of internal medicine.

[28]  B. Weinshenker,et al.  Natural history of multiple sclerosis , 1994, Annals of neurology.

[29]  Shelley E. Taylor,et al.  Psychological resources, positive illusions, and health. , 2000, The American psychologist.

[30]  N. Wineman.  Adaptation to Multiple Sclerosis: The Role of Social Support, Functional Disability, and Perceived Uncertainty , 1990, Nursing research.

[31]  A. Janssens,et al.  Expectations of wheelchair‐dependency in recently diagnosed patients with multiple sclerosis and their partners , 2003, European journal of neurology.

[32]  R. Snaith,et al.  The Hospital Anxiety and Depression Scale , 1983 .

[33]  M. Horowitz,et al.  Impact of Event Scale: A Measure of Subjective Stress , 1979, Psychosomatic medicine.

[34]  B Bass,et al.  The natural history of multiple sclerosis: a geographically based study. I. Clinical course and disability. , 1989, Brain : a journal of neurology.