Deciphering Depressive Mood in Relapsing-Remitting and Progressive Multiple Sclerosis and Its Consequence on Quality of Life.

Delphine Lamargue Hamel,Jean-Christophe Ouallet,Bruno Brochet,Mathilde Deloire,Julie Charré-Morin,Aurore Saubusse,Aurélie Ruet,Friedemann Paul

doi:10.1371/journal.pone.0142152

Delphine Lamargue Hamel, Jean-Christophe Ouallet + Show 6 more

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https://doi.org/10.1371/journal.pone.0142152

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Abstract

BackgroundDepressive mood and other emotional symptoms are common in multiple sclerosis (MS). The patient-reported outcome version of the “Echelle d’Humeur Dépressive” (EHD-PRO) aims to differentiate between two dimensions of depressive mood in people living with MS (PwMS).ObjectivesFirst, to compare EHD-PRO assessment and its two dimensions, lack of emotional control and emotional blunting, between a large sample of healthy controls (HCs) and two samples of PwMS, relapsing-remitting MS (RRMS) and primary progressive MS (PPMS); and second, to analyse the relationships between EHD-PRO scores with neurological disability, cognitive function, fatigue and health-related quality of life (HR-QOL).ResultsRegardless of their phenotype, PwMS had significantly higher EHD-PRO scores than HCs. EHD-PRO scores did not differ between the two MS groups. EHD-PRO scores did not correlate with disability and fatigue scores, disease duration or cognitive z scores. In RRMS, the lack of emotional control was independently associated with a decrease in HR-QOL.ConclusionThe EHD-PRO is able to easily detect depressive mood and to differentiate between two clinical dimensions, emotional blunting and lack of emotional control. The scale is sensitive and seems robust to confounding factors. Lack of emotional control seems to contribute significantly to altered HR-QOL in RRMS.

Highlights

Depressive mood (DM), anxiety and other emotional symptoms are more frequent in people living with multiple sclerosis (PwMS) than in the general population [1]
In relapsing-remitting MS (RRMS), the lack of emotional control was independently associated with a decrease in health-related quality of life (HR-QOL)
Depressive Mood in Multiple Sclerosis they have nothing else to disclose in relation with this study

Summary

Introduction

Depressive mood (DM), anxiety and other emotional symptoms are more frequent in people living with multiple sclerosis (PwMS) than in the general population [1]. The focus of the EHD is not to determine a global score of depression; instead, it aims to characterize various emotional dimensions It enables the identification of subjects who lack major depression or generalized anxiety disorder but who do have significant emotional disturbances. The authors performed principal components analysis, which revealed 5 factors: emotional blunting (EB), emotional incontinence, explosive mood/irritability, emotional lability and painful sadness [7] From these factors the authors distinguished two clinical dimensions, emotional deficits and the lack of emotional control (EC) and proposed a dichotomy between depression in which inhibition predominates and depression in which anxious or agitated symptoms predominate [8]. The patient-reported outcome version of the “Echelle d’Humeur Dépressive” (EHD-PRO) aims to differentiate between two dimensions of depressive mood in people living with MS (PwMS)

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