Depression mediates the relationship between fatigue and mental health-related quality of life in multiple sclerosis

Baseline data from a population-based study examining the health-related quality of life (HRQL) of MS patients about to begin disease modifying therapy was used to determine the factors associated with the HRQL of Saskatchewan adults with relapsing-remitting MS. Participants completed a self-report questionnaire regarding demographic and socioeconomic status, fatigue, comorbid medical conditions, disability level (EDSS), number of attacks in past 6 months, illness intrusiveness (Illness Intrusiveness Ratings Scale), depression (Beck Depression Inventory), and HRQL (SF-36 Health Status Survey). Multiple linear regression models were used to identify the factors associated with the physical and mental health summary scores of the SF-36. We found poorer physical HRQL in those who are female; older; not working; have musculoskeletal or respiratory problems; greater fatigue, higher disability scores, and more MS attacks. High illness intrusiveness; digestive system problems; genitourinary problems; and headaches were associated with poorer mental HRQL. Interestingly, we found an interaction between sex and age in mental HRQL, with worse mental health in older men but better mental health in older women. These findings may assist health care providers in identifying patients who may be at risk for decline in their HRQL, permitting appropriate and timely interventions. Multiple Sclerosis 2007; 13: 1038—1045. http://msj.sagepub.com

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The relationship among Mental Health Status (GHQ-12), Health Related Quality of Life (EQ-5D) and Health-State Utilities in a general population

Epidemiologia e Psichiatria Sociale ◽

10.1017/s1121189x00000518 ◽

2009 ◽

Vol 18 (3) ◽

pp. 229-239 ◽

Cited By ~ 20

Author(s):

Pedro Serrano-Aguilar ◽

Yolanda Ramallo-Fariña ◽

Maria Del Mar Trujillo-Martín ◽

Sergio Raul Muñoz-Navarro ◽

Lilisbeth Perestelo-Perez ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

General Population ◽

Forecast Errors ◽

Health State ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

The Relationship

SUMMARYAim – To assess the relationship between mental health and health-related quality of life (HRQL) in the general population, and to map GHQ-12 as a screening test for population psychological distress to a generic health state measure (EQ-5D) in order to estimate health state values and allow deriving quality-adjusted life years. Methods – Relationship between mental health and HRQL was examined from the 2004 Canary Islands’ Health Survey. Participants were classified as probable psychiatric cases according to GHQ-12. HRQL was measured by the EQ-5D index. Multivariate lineal regression analysis was used to examine the association between mental health and HRQL adjusting by socio-demographic variables and comorbidities. A multivariate regression model was built from EQ-5D to estimate health states values using GHQ-12 as exposure. Results – EQ-5D index scores decreased as the GHQ-12 scores increased. Clinical and socio-demographic factors influenced HRQL without changing the overall trend for this negative relationship. The regression equation explained 43% of the variance. For estimation of utility scores, the model showed a high predictive capacity, with a mean forecast errors of 16%. Conclusions – HRQL progressively decreased when the probability of being a psychiatric case increased. Findings enable health state values to be derived from GHQ-12 scores for populations where utilities has not or cannot be measured directly.Declaration of Interest: Authors declare no conflicts of interest. This work was supported by the Quality Plan for the National Health Service (Spanish Ministry of Health and Social Policy).

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Gender differences in health-related quality of life in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458509107016 ◽

2009 ◽

Vol 15 (11) ◽

pp. 1339-1346 ◽

Cited By ~ 34

Author(s):

Ilaria Casetta ◽

Trond Riise ◽

Monica Wamme Nortvedt ◽

Nicola Tiberio Economou ◽

Riccardo De Gennaro ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Multiple Sclerosis ◽

Physical Functioning ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

The Impact ◽

Gender Specific

Women have about twice the risk of developing multiple sclerosis (MS) compared with men, a ratio that seems to be increasing. Most studies show that female patients seem to have a more favourable outcome of the disease. We studied the gender-specific impact of MS on health-related quality of life. We surveyed the population prevalence of MS patients in Ferrara, Italy. Data were extracted from the MS registry of the study area. Health-related quality of life was assessed using the MSQOL54 questionnaire. We analysed 370 patients (105 men and 265 women). They had worse scores than the general population in all health-related quality of life dimensions, ranging from 2.5 standard deviations (SD) lower for physical functioning to less than 0.5 standard deviations for mental health. Health-related quality of life scores were inversely correlated with disability scores. The impact of disability on health-related quality of life was higher for men than women regarding physical functioning (p < 0.01), vitality (p < 0.001), social functioning (p < 0.001), emotional wellbeing (p < 0.05) and mental health (p < 0.01). For scales reflecting mental health, a marked reduction with increasing disability was seen for men, while a linear reduction in the range of Expanded Disability Status Scale score 0—5 was reported for women, followed by no clear decrease for higher scores. We conclude that MS affects health-related quality of life in all of its dimensions. The impact of disability seems to be stronger among men, in particular for scales related to mental well-being. This could indicate that interventions should to be gender specific in order to better meet patients’ needs.

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Examining the relationship between health-related quality of life in individuals with spinal cord injury and the mental health of their caregivers in Colombia, South America

International Journal of Rehabilitation Research ◽

10.1097/mrr.0b013e3283634e7f ◽

2013 ◽

Vol 36 (4) ◽

pp. 308-314 ◽

Cited By ~ 6

Author(s):

Jennifer A. Coleman ◽

Leia A. Harper ◽

Paul B. Perrin ◽

Silvia L. Olivera ◽

Jose L. Perdomo ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Health Related Quality ◽

Cord Injury ◽

Related Quality ◽

Health Related ◽

The Relationship

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Relating health-related Quality of Life to disability progression in multiple sclerosis, using the 5-level EQ-5D

Multiple Sclerosis Journal ◽

10.1177/1352458512474860 ◽

2013 ◽

Vol 19 (9) ◽

pp. 1190-1196 ◽

Cited By ~ 17

Author(s):

Emer Fogarty ◽

Cathal Walsh ◽

Roisin Adams ◽

Christopher McGuigan ◽

Michael Barry ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Resource Allocation ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Anxiety Depression ◽

The Relationship ◽

Inform Resource Allocation

Background: Increasing use of the Quality-Adjusted Life-Year to inform resource allocation decision-making has highlighted the importance of relating clinical and health-related quality of life (HRQoL) outcomes in multiple sclerosis (MS) patients. Objective and Methods: To investigate the relationship between the Expanded Disability Status Scale (EDSS) and HRQoL utility, using the 5-level EQ-5D (EQ-5D-5L). The discriminatory power of the EQ-5D-5L was assessed using Shannon’s indices. Results: A linear decline in utility was observed with changes in EDSS score from 0 to 6, after which point the relationship exhibited greater variability. Mean utility values ranged from −0.22 at EDSS 9 to 0.88 at EDSS 0. We found that the discriminative capacity of the EQ-5D-5L was considerably lower for the domains self-care and anxiety/depression, compared with other health-related domains. Conclusion: In its first reported use in an MS population, the EQ-5D-5L displayed good discriminatory capacity, although performance differed between the various domains of health, with evidence of a ceiling effect present in the domains of self-care and anxiety/depression. The EQ-5D-5L demonstrated a high correlation with EDSS in our MS cohort up to EDSS 6, after which point the utility valuation of severe health states exhibited much greater variability. Utility estimates from this study may be used in economic evaluations of disease-modifying therapies in MS, to inform resource-allocation decisions.

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