Fear of relapse, social support, and psychological well-being (depression, anxiety, and stress level) of patients with multiple sclerosis (MS) during the COVID-19 pandemic stage

Abstract

Background Psychological well-being assessment during the COVID-19 pandemic is essential for patients with multiple sclerosis (MS). The goal of this study is to evaluate fear of relapse, social support, and psychological well-being (depression, anxiety, and stress level) of Iranian patients with MS during the COVID-19 pandemic stage. Methods One hundred and sixty-five patients were enrolled. We asked all cases to fill valid and reliable Persian version of depression, anxiety, and stress scale (DASS-21), perceived social support, and fear of relapse scale questionnaires. Results One hundred and sixty-five patients were enrolled. Female to male ratio was (F/M) = 4.6. Mean age and mean duration of disease were 35.3±8.6 and 7.1±5 years, respectively. Mean scores of social support, DASS, and FoR questionnaires were 63.1±16.8, 16.4±13.4, and 51.4±17.3, respectively. There was a significant negative correlation between social support and FoR scores and also significant positive correlations between components of DASS and FoR. Linear regression analysis by considering FoR as dependent variable and age, sex, marital status, duration of the disease, and EDSS as dependent variables showed that sex was an independent predictor of FoR score. Conclusion Psychological well-being as well as fear of relapse should be considered in patients with MS during the COVID-19 pandemic stage.

Psychological impacts of COVID-19 pandemic on individuals living with multiple sclerosis: A rapid systematic review

“…Most of the studies (n=14) used online surveys for data collection. Four studies excluded participants with comorbid psychiatric conditions ( Altunan et al, 2021 ; Chiaravalloti et al, 2021 ; Demir et al, 2020 ; Stojanov et al, 2020 ), nine studies did not mention pre-existing psychiatric comorbidities prior to the onset of the COVID-19 outbreak ( Alschuler et al, 2021 ; Andreu-Caravaca et al, 2021 ; Bonavita et al, 2020 ; Broche-Perez et al, 2021 ; Capuano et al, 2021 ; Dilek et al, 2021 ; Naser Moghadasi, 2020 ; Shaygannejad et al, 2021b ; Talaat et al, 2020 ), and the remaining six articles reported baseline psychiatric comorbidity status ( Costabile et al, 2020 ; Garjani et al, 2021 ; Motolese et al, 2020 ; Ramezani et al, 2021 ; Shaygannejad et al, 2021a ; Zanghi et al, 2020 ).…”

“…Anxiety was the primary outcome variable in 16 (84.2%) of the included studies ( Alschuler et al, 2021 ; Andreu-Caravaca et al, 2021 ; Broche-Perez et al, 2021 ; Capuano et al, 2021 ; Chiaravalloti et al, 2021 ; Demir et al, 2020 ; Dilek et al, 2021 ; Garjani et al, 2021 ; Motolese et al, 2020 ; Naser Moghadasi, 2020 ; Ramezani et al, 2021 ; Shaygannejad et al, 2021a ; Shaygannejad et al, 2021b ; Stojanov et al, 2020 ; Talaat et al, 2020 ; Zanghi et al, 2020 ). Measurement scales used to assess anxiety included the Depression Anxiety Stress Scales-21 (DASS-21) (n=4) ( Shaygannejad et al, 2021a ; Shaygannejad et al, 2021b ; Talaat et al, 2020 ; Zanghi et al, 2020 ); the State-Trait Anxiety Inventory (STAI) (n=3)( Andreu-Caravaca et al, 2021 ; Capuano et al, 2021 ; Dilek et al, 2021 ); the Hospital Anxiety and Depression Scale (HADS) (n=3) ( Chiaravalloti et al, 2021 ; Garjani et al, 2021 ; Ramezani et al, 2021 ); the Generalized Anxiety Disorder-7(GAD-7) (n=3)( Broche-Perez et al, 2021 ; Garjani et al, 2021 ; Motolese et al, 2020 ); the Beck Anxiety Inventory (BAI) (n=2) ( Demir et al, 2020 ; Naser Moghadasi, 2020 ); the Hamilton scales for anxiety (HAM-A) (n=1)( Stojanov et al, 2020 ); and the PROMIS Short Form v1.0 – Anxiety 6a (n=1)( Alschuler et al, 2021 ). One study used two scales to assess anxiety in their participants ( Garjani et al, 2021 ).…”

“…A Turkish study of paediatric MS (n=30) found that 100% of the sample reported clinically meaningful anxiety during lockdown ( Dilek et al, 2021 ). It is noteworthy that two studies only reported the average severity of anxiety symptoms in their samples rather than the frequency of different severity groups or categories ( Broche-Perez et al, 2021 ; Shaygannejad et al, 2021b ).…”

“…Fourteen studies (73.7%) examined depression among PwMS ( Alschuler et al, 2021 ; Bonavita et al, 2020 ; Broche-Perez et al, 2021 ; Capuano et al, 2021 ; Chiaravalloti et al, 2021 ; Demir et al, 2020 ; Garjani et al, 2021 ; Motolese et al, 2020 ; Ramezani et al, 2021 ; Shaygannejad et al, 2021a ; Shaygannejad et al, 2021b ; Stojanov et al, 2020 ; Talaat et al, 2020 ; Zanghi et al, 2020 ). They used a variety of scales, including the Beck Depression Inventory-II (BDI-II) (n=5)( Broche-Perez et al, 2021 ; Capuano et al, 2021 ; Chiaravalloti et al, 2021 ; Demir et al, 2020 ; Motolese et al, 2020 ); the Depression Anxiety Stress Scales-21 (DASS-21) (n=4)( Shaygannejad et al, 2021a ; Shaygannejad et al, 2021b ; Talaat et al, 2020 ; Zanghi et al, 2020 ); and the Hospital Anxiety and Depression Scale (HADS) (n=3)( Chiaravalloti et al, 2021 ; Garjani et al, 2021 ; Ramezani et al, 2021 ); the Hamilton scales for Depression (HAM-D) (n=1)( Stojanov et al, 2020 ); the PROMIS Short Form v1.0 – Depression 6a (n=1)( Alschuler et al, 2021 ); the Patient Health Questionnaire -2 (PHQ-2) (n=1)( Bonavita et al, 2020 ); and Patient Health Questionnaire -9 (PHQ-9) (n=1)( Garjani et al, 2021 ). Two studies used two different scales to assess depression in their participants ( Chiaravalloti et al, 2021 ; Garjani et al, 2021 ).…”

“…All eight reported the frequency of stress-related symptoms. Four studies assessed stress among PwMS during the COVID-19 pandemic using the DASS-21 ( Shaygannejad et al, 2021a ; Shaygannejad et al, 2021b ; Talaat et al, 2020 ; Zanghi et al, 2020 ). Severe to extremely severe stress levels were reported in 16% and 34% of cases in Italy ( Zanghi et al, 2020 ) and Egypt ( Talaat et al, 2020 ), respectively.…”