Coping et qualité de vie dans la sclérose en plaques et la maladie de Parkinson : une réflexion clinique

Abstract

Objective In neurological disorders, such as multiple sclerosis (MS) and Parkinson’ s disease (PD), psychological and adaptive processes have not been extensively investigated, it has, however, been demonstrated that they have a great impact on “quality of life” (QoL). Interestingly, even though these two diseases affect people of different ages, both of them have a substantial impact on mood and QoL. In these two diseases, the authors objective was to analyse the style of coping in relation with the QoL taking depression and anxiety into account. Methods Two hundred and seventy MS and PD subjects were seen for a semistructured interview in order to collect sociodemographic and clinical information, after which there was an assessment of their mental and cognitive states using: the Mini International Neuropsychiatric Interview (MINI), the Montgomery and Asberg Depression Rating Scale (MADRS), the Depressive Mood Scale (EHD), the Hamilton Anxiety scale (HAMA) and the Frontal Assessment Battery (FAB). Then, all subjects completed three self-report questionnaires; two about coping strategies: the Ways of Coping Checklist (WCC), the Coping with Health, Injuries and Problems scale (CHIP), and one about QoL: the SEP 59 for MS and the French version of PDQ-39 for PD. Results The studies show that the psychosocial dimension of QoL is preserved in the two diseases studied. They also demonstrated that in MS and PD the two factors associated with a poor QoL are depression and emotion-focused coping strategies. Furthermore, these variables are highly dependent on the clinical courses in MS and motor signs in PD. However, the MS patients tended to be more irritable and to lose the control of their emotions more easily than PD patients. Discussion The report discusses the importance, first, of identifying these manifestations in patients with MS or PD and, second, of offering patients interventions tailored to the characteristics of each disorder. The authors propose some examples of psychotherapy, which could be used with neurological patients. The studies show that it is also important to work with MS and PD patients on both the expression and the management of their emotions in connection with their diseases.