Abstract
BackgroundMultiple sclerosis (MS) is associated with a physical disability and disturbed psychosocial functioning in young people. Many psychological and psychiatric comorbidities have been reported in MS.ObjectiveTo determine the frequency of social anxiety disorder (SAD) and obsessive-compulsive disorder (OCD) among MS patients and their relation to MS severity.MethodsA cross-sectional survey was conducted in an adult MS cohort. Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Social Phobia Inventory (SPIN) were used to determine the presence and severity of OCD and SAD. The Statistical Package for the Social Sciences (SPSS) version 22 (IBM Corp., Armonk, NY) was used for statistical analysis. The Mann-Whitney U test and logistic regression were used to assess the association of the two diseases with the severity of MS.ResultsA total of 145 persons with MS (pwMS) were studied. The mean age was 33.5 (±8.5) years; the mean duration of MS was 7.2 (± 5.1) years. The majority (74.1%) were women; 57.3% were married; 63% had a college education; 50% belonged to the higher middle-class socioeconomic strata. Relapsing-remitting multiple sclerosis was the most common type of MS (92.2%). The mean Expanded Disability Status Scale (EDSS) score was 2.24 (±2.19). SAD was reported by 26.9%, and OCD was reported by 31% of the cohort. PwMS with walking difficulty but not wheelchair-bound had a statistically significant increased risk of SAD (p = 0.036). There was no direct association between MS-related disability and OCD. However, pwMS with SAD were more likely to have concomitant OCD (t=4.68, p-value <0.001, 95% CI: 0.47-1.16). Increasing disability was associated with higher chances of developing social anxiety and, in turn, OCD (t=3.39, p-value <0.001, 95% CI: 0.66-2.52).ConclusionsSocial anxiety and obsessive-compulsive disorders were present in nearly one-third of pwMS. Impaired walking but not wheelchair dependence was associated with social anxiety. PwMS with SAD were more likely to have obsessive-compulsive disorder.
Highlights
Multiple sclerosis (MS) is a neurodegenerative, progressive, multifocal demyelinating disease of the central nervous system [1]
social anxiety disorder (SAD) was reported by 26.9%, and obsessive-compulsive disorder (OCD) was reported by 31% of the cohort
Increasing disability was associated with higher chances of developing social anxiety and, in turn, OCD (t=3.39, p-value
Summary
Multiple sclerosis (MS) is a neurodegenerative, progressive, multifocal demyelinating disease of the central nervous system [1]. The most common pattern of MS is the relapsing-remitting MS (RRMS) with a prevalence of (85%-90%), followed by secondary progressive MS. The global prevalence of MS is 30 per 100,000, with an incidence rate of 2.5 per 100,000 per year [4]. In a recent Saudi study, the prevalence of MS was 40.4/100,000 population, with threefourths of pwMS younger than 40 years of age and a female to male ratio of 2:1 [6]. A local Saudi study from 1998 suggested that the onset was mostly in the third decade, with the majority of pwMS having RRMS [7]. Many psychological and psychiatric comorbidities have been reported in MS
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