Determining Factors of Self-Esteem in Patients with Multiple Sclerosis

Abstract

Self-esteem is the result of a personal self-view. Level of self-esteem is lower in patients with multiple sclerosis (MS). The aim of our study was to investigate the determining factors of a decrease in self-esteem in MS patients. We conducted a prospective cross-sectional study in the department of Neurology of Razi Hospital between March and April 2019. We included MS patients diagnosed with 2017 McDonald criteria and aged over 18 years. We excluded those with medical or surgical comorbidities, severe cognitive impairment and decompensated psychiatric disorders. We evaluated Self Esteem with the Rosenberg auto-questionnaire. A score less than or equal to 34 indicates a decrease in self-esteem. We also evaluated fatigue (Fatigue Severity Scale (FSS)), self-efficacy (General Self-Efficacy Scale (GSE)), bladder disturbances (Bladder Control Scale (BLCS)), functioning of upper limbs, and quality of life (self-questionnaire (SEP-59) and of environment (Environmental Quality measurement (EQM)). We measured disability using the Expanded Disability Status Scale (EDSS) and the MS Severity Scale (MSSS). The statistical tests were performed at the 0.05 level of significance using the Statistical Package for the Social Sciences software version 23.0 (SPSS). We included 50 patients (sex-ratio F/M = 5.2). Mean age was 34 years. Self esteem was decreased in 60% of our patients. A significant association was found between alteration of self-esteem, alteration of self-efficacy, gait disorders, spasticity, dexterity impairment, urinary disorders, higher EDSS and MSSS scores and the use of assistive devices. Decreased Self-esteem has not been correlated with prehension and coordination difficulties, sexual disorders and fatigue. Self-esteem was more impaired in our patients compared to previous studies. It depends on motor disability, bladder disturbances and dependence to the environment. A reproducible assessment of Self-esteem is required in the management of MS patients.