Abstract
Objectives: Stress is supposed to be linked with a background of multiple sclerosis (MS) and the disease course. Design: The study aimed to assess the level of stress and coping strategies in MS patients within a year of follow-up and to investigate the relationships between these aspects and factors related—or not—to MS. Methods: In 65 patients with MS, the Perceived Stress Scale (PSS-10), Type D Scale (DS14) and Coping Orientations to Problems Experienced (COPE) were performed at baseline and after a year. Baseline PSS-10, DS-14 and COPE scores were analyzed with regard to demographics, MS duration, treatment, indices of disability and self-reported stressful events (SEs). Final PSS-10 and COPE results were analyzed with reference to MS activity and SE within a year of follow-up. Results: Initially, 67% of patients reported a moderate or high level of stress and 31% met Type-D personality criteria. Diverse coping strategies were preferred, most of which were problem-focused. The negative affectivity DS-14 subscore (NEG) was correlated with disability level. Non-health-related SEs were associated with higher PSS-10 and NEG scores. After a year, the mean PSS-10 score decreased, while COPE results did not change significantly. Non-health-related SEs were associated with a higher PSS-10 score and less frequent use of acceptance and humor strategies. Those with an active vs. stable MS course during the follow-up did not differ in terms of PSS-10 and COPE results. Conclusions: MS patients experienced an increased level of stress. No significant relationships were found between stress or coping and MS course within a year. Non-health-related factors affected measures of stress more than MS-related factors.
Highlights
IntroductionThere is ongoing research on the role of factors influencing this course
The majority of Multiple sclerosis (MS) patients experience moderate to high levels of stress
Non-disease-related factors affect the measures of stress more than MS-related variables
Summary
There is ongoing research on the role of factors influencing this course Among these factors, stress is of great interest, especially in view of patient-related outcomes associated with their quality of life [2,3]. Several links have been established between MS etiology and biological mechanisms of stress, including hyperreactivity of the hypothalamic–pituitary–adrenal gland (HPA) axis, dysregulation of the autonomic system and subsequent modulation of the (auto)immune response [4,5,6]. These mechanisms can be affected by the immunomodulating or immunosuppressive mechanisms of various types of diseasemodifying therapies (DMT) used in MS
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