Threatening Illness Perception and Associated Factors in Early-stage Relapsing Remitting Multiple Sclerosis
Susana Sainz de la Maza1, Rocío Gómez-Ballesteros2, Mónica Borges3, Jesús Martín-Martínez4, Javier Sotoca5, Ana Alonso6, Ana B Caminero7, Laura Borrega8, José L Sánchez-Menoyo9, Francisco J Barrero-Hernández10, Carmen Calles11, Luis Brieva12, María R Blasco-Quílez13, Julio Dotor Garcia-Soto3, María del Campo-Amigo14, Laura Navarro-Cantó15, Eduardo Agüera16, Moisés Garcés-Redondo17, Olga Carmona18, Laura Gabaldón-Torres19, Lucía Forero20, Mariona Hervás21, Jorge Maurino2, Tamara Castillo-Trivino22
1Hospital Universitario Ramón y Cajal, 2Medical Department, Roche Farma, 3Hospital Universitario Virgen Macarena, 4Hospital Universitario Miguel Servet, 5Hospital Universitari Mútua Terrassa, 6Hospital Regional Universitario de Málaga, 7Complejo Asistencial de Ávila, 8Hospital Universitario Fundación Alcorcón, 9Hospital de Galdakao-Usansolo, 10Hospital Universitario Clínico San Cecilio, 11Hospital Universitari Son Espases, 12Hospital Universitari Arnau de Vilanova, 13Hospital Universitario Puerta de Hierro, 14Complexo Hospitalario Universitario de Pontevedra, 15Hospital General Universitario de Elche, 16Hospital Universitario Reina Sofía, 17Hospital Clínico Universitario Lozano Blesa, 18Fundació Salut Empordà, 19Hospital Francesc de Borja, 20Hospital Universitario Puerta del Mar, 21Consorci Corporació Sanitària Parc Taulí, 22Hospital Universitario Donostia
Objective:

The aim of this study was to assess the illness perception and associated factors in early-stage relapsing remitting multiple sclerosis (RRMS) patients.

Background:

Patients with early-stage RRMS experience uncertainty and intense emotions as diagnosis is disclosed. Illness perception at this point can influence levels of adjustment, coping strategies, and patients’ well-being.

Design/Methods:

A multicentre, non-interventional study was conducted. Adult patients with RRMS, disease duration ≤3 years, and Expanded Disability Status Scale (EDSS) score between 0-5.5 were included. The Brief-Illness Perception Questionnaire (B-IPQ) was used to assess patients’ cognitive and emotional illness representation. Patient-reported measures were administered to gather information on different outcomes.

A multivariate logistic regression analysis was performed to assess the association between B-IPQ and demographic, clinical characteristics, and patients’ perspectives.
Results:

A total of 189 patients were included (mean age: 36.1±9.4 years, 71.4% female, mean disease duration: 1.4±0.8 years). Median EDSS score was 1.0 (IQR=0.0-2.0).

A proportion of 36.5% (n=69/189) patients had a moderate-to-high threatening illness perception, and 45.5% of patients thought that their MS was caused by psychological factors.

Bivariate analyses suggested that patients were significantly more likely to have a threatening disease perception if they were unemployed, received symptomatic treatment, had a higher EDSS, worse hand dexterity and gait, higher perception of pain, fatigue, symptom severity, hopelessness, and worse perception of their quality of life. Also patients that reported workplace barriers, cognitive complaints, and probable cases of anxiety, depression, and stigma.

Higher EDSS, symptom severity, worse psychological quality of life, perception of stigma, and higher hopelessness-trait were predictors of moderate-to-high threatening illness perception (OR=2.349, 95%CI:1.276-5.130; OR=1.208, 95%CI:1.089-1.364; OR=1.051, 95%CI:1.018-1.089; OR=3.365, 95%CI:1.152-10.796; OR=41.177, 95%CI:6.942-388.825, respectively, all p<0.05).

Conclusions:
Threatening illness perceptions are common among patients with early RRMS. Identifying these beliefs and its associated factors and establishing individualized interventions may help patients deal with their condition.
10.1212/WNL.0000000000202951