scholarly journals Validation of NARCOMS Depression Scale

2008 ◽  
Vol 10 (3) ◽  
pp. 81-84 ◽  
Author(s):  
Ruth Ann Marrie ◽  
Gary Cutter ◽  
Tuula Tyry ◽  
Denise Campagnolo ◽  
Timothy Vollmer
Keyword(s):  
Multiple Sclerosis ◽  
Body Mass Index ◽  
Convergent Validity ◽  
Depression Scale ◽  
Epidemiologic Studies ◽  
Divergent Validity ◽  
Research Committee ◽  
The North ◽  
American Research ◽  
Registry Report

Participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) registry report depression with one question. We aimed to validate the NARCOMS depression scale against the Center for Epidemiologic Studies Depression Scale (CESD) and self-reported diagnoses of depression. The NARCOMS scale correlated with the CESD (r = 0.73; 95% confidence interval 0.72–0.74), and a score ≥2 had a sensitivity of 87% and specificity of 92% for depression. Correlations between the NARCOMS scale and age and body mass index were low, indicating divergent validity, whereas correlations with pain and fatigue were moderate, indicating convergent validity. The NARCOMS depression scale has adequate criterion and construct validity in MS.

The burden of mental comorbidity in multiple sclerosis: frequent, underdiagnosed, and undertreated

2009 ◽  
Vol 15 (3) ◽  
pp. 385-392 ◽  
Author(s):  
RA Marrie ◽  
R Horwitz ◽  
G Cutter ◽  
T Tyry ◽  
D Campagnolo ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Socioeconomic Status ◽  
Depression Scale ◽  
Epidemiologic Studies ◽  
Lower Socioeconomic Status ◽  
Research Committee ◽  
The North ◽  
Lower Socioeconomic ◽  
Mental Comorbidities ◽  
Mental Comorbidity

Background Mental comorbidity is common in multiple sclerosis (MS), but some studies suggest that mental comorbidity may be underrecognized and undertreated. Objective Using the North American Research Committee on MS Registry, we assessed the frequency of mental comorbidities in MS and sociodemographic characteristics associated with diagnosis and treatment of depression. Methods We queried participants regarding depression, anxiety, bipolar disorder, and schizophrenia. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CESD); a score ≥21 indicated probable major depression. Results Mental comorbidity affected 4264 (48%) responders; depression most frequently (4012, 46%). Among participants not reporting mental comorbidity, 751 (16.2%) had CESD scores ≥21 suggesting undiagnosed depression. Lower socioeconomic status was associated with increased odds of depression (Income $15,000–30,000 vs >$100,000 OR 1.34; 1.11–1.62), undiagnosed depression (Income $15,000–30,000 vs >$100,000 OR 1.52; 1.08–2.13), and untreated depression (<high school vs postgraduate degree OR 3.13; 1.65–5.99). Conclusions Mental comorbidity remains underdiagnosed and undertreated in MS. Patients of lower socioeconomic status bear a disproportionate share of the burden of depression.

Validation of the NARCOMS Registry: fatigue assessment

2005 ◽  
Vol 11 (5) ◽  
pp. 583-584 ◽  
Author(s):  
Ruth Ann Marrie ◽  
Gary Cutter ◽  
Tuula Tyry ◽  
Olympia Hadjimichael ◽  
Denise Campagnolo ◽  
...  
Keyword(s):  
Construct Validity ◽  
Convergent Validity ◽  
Disease Duration ◽  
Research Committee ◽  
The North ◽  
Impact Scale ◽  
Fatigue Severity ◽  
Fatigue Impact Scale ◽  
American Research ◽  
Registry Report

Participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry report disability using Performance Scales (PS), which assess eight domains. We aimed to validate the PS fatigue subscale (PSF) using the Fatigue Severity Scale (FSS) and the Modified Fatigue Impact Scale (MFIS) as external criteria. We measured correlations between the PSF and age, disease duration and PS subscales to assess construct validity. The PSF correlated strongly with the MFIS (r=0.72, p<0.0001) and FSS (r=0.75, p<0.0001). Correlations between the PSF and age, disease duration were low, indicating divergent validity. Correlations between the PSF and spasticity, sensory and mobility PS scales were moderate, indicating convergent validity. The PSF has adequate criterion and construct validity in MS.

Effect of Physical Comorbidities on Risk of Depression in Multiple Sclerosis

2009 ◽  
Vol 11 (4) ◽  
pp. 161-165 ◽  
Author(s):  
Ruth Ann Marrie ◽  
Gary Cutter ◽  
Tuula Tyry ◽  
Denise Campagnolo ◽  
Timothy Vollmer
Keyword(s):  
Multiple Sclerosis ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Depression Scale ◽  
Epidemiologic Studies ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Research Committee ◽  
The North ◽  
Increased Risk

Depression in multiple sclerosis (MS) may be due to several factors, including the presence of physical comorbidities. Using the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry, we examined whether individuals with MS and physical comorbidities have an increased risk of depression compared with those without physical comorbidities and whether they are more likely to remain untreated for depression. In 2006, NARCOMS participants reported their physical and mental comorbidities and completed the Center for Epidemiologic Studies Depression Scale (CESD). We defined a CESD score of 21 or higher as indicating probable major depression. Individuals with elevated CESD scores but no diagnosis of depression were considered undiagnosed. Forty-six percent of participants reported a lifetime history of depression. In a multivariable Cox proportional hazards model, reporting any physical comorbidity was associated with an increased risk of being diagnosed with depression (hazard ratio [HR], 2.20; 95% confidence interval [CI], 2.04–2.38) after MS onset and with an increased risk of diagnosed or undiagnosed depression (HR, 2.37; 95% CI, 2.21–2.54). After adjustment for education, participants with any physical comorbidity were more likely to report treatment for depression (odds ratio [OR], 1.67; 95% CI, 1.24–2.23). Patients with MS and physical comorbidities are at increased risk of depression, but they are more likely to be diagnosed and treated than MS patients without other chronic conditions.

Validation of the NARCOMS Registry: pain assessment

2005 ◽  
Vol 11 (3) ◽  
pp. 338-342 ◽  
Author(s):  
Ruth Ann Marrie ◽  
Gary Cutter ◽  
Tuula Tyry ◽  
Olympia Hadjimichael ◽  
Timothy Vollmer
Keyword(s):  
Multiple Sclerosis ◽  
Convergent Validity ◽  
Disease Duration ◽  
Self Report ◽  
Research Committee ◽  
Retest Reliability ◽  
The North ◽  
Disability Status ◽  
Pain Question ◽  
Test Retest Reliability

The North American Research Committee on Multiple Sclerosis (NARCOMS) Registry is a multiple sclerosis (MS) self-report registry with more than 24 000 participants. Participants report disability status upon enrolment, and semi-annually using Performance Scales (PS), Patient Determined Disease Steps (PDDS) and a pain question. In November 2000 and 2001, we also collected the Pain Effects Scale (PES). Our aim was to validate the NARCOMS pain question using the PES as our criterion measure. We measured correlations between the pain question and age, disease duration, various PS subscales and PDDS to assess construct validity. We correlated pain question responses in participants who reported no change in PDSS or the PS subscales between questionnaires to determine test—retest reliability. We measured responsiveness in participants who reported a substantial change in the sensory, spasticity PS subscales. The correlation between the pain question and PES was r=0.61 in November 2000, and r=0.64 in November 2001 (both P<0.0001). Correlations between the pain question and age, and disease duration were low, indicating divergent validity. Correlations between the pain question and spasticity, sensory PS subscales and PDSS were moderate, indicating convergent validity. Test—retest reliability was r=0.84 (P<0.0001). Responsiveness was 70.7%. The pain question is a valid self-report measure of pain in MS.

Substantial adverse association of visual and vascular comorbidities on visual disability in multiple sclerosis

2011 ◽  
Vol 17 (12) ◽  
pp. 1464-1471 ◽  
Author(s):  
Ruth Ann Marrie ◽  
Gary Cutter ◽  
Tuula Tyry
Keyword(s):  
Multiple Sclerosis ◽  
Cox Regression ◽  
Cox Model ◽  
Contributing Factors ◽  
Visual Disability ◽  
Research Committee ◽  
The North ◽  
American Research ◽  
The Impact ◽  
Vascular Comorbidity

Background: Visual comorbidities are common in multiple sclerosis (MS) but the impact of visual comorbidities on visual disability is unknown. Objective: We assessed the impact of visual and vascular comorbidities on severity of visual disability in MS. Methods: In 2006, we queried participants of the North American Research Committee on Multiple Sclerosis (NARCOMS) about cataracts, glaucoma, uveitis, hypertension, hypercholesterolemia, heart disease, diabetes and peripheral vascular disease. We assessed visual disability using the Vision subscale of Performance Scales. Using Cox regression, we investigated whether visual or vascular comorbidities affected the time between MS symptom onset and the development of mild, moderate and severe visual disability. Results: Of 8983 respondents, 1415 (15.9%) reported a visual comorbidity while 4745 (52.8%) reported a vascular comorbidity. The median (interquartile range) visual score was 1 (0–2). In a multivariable Cox model the risk of mild visual disability was higher among participants with vascular (hazard ratio [HR] 1.45; 95% confidence interval [CI]: 1.39–1.51) and visual comorbidities (HR 1.47; 95% CI: 1.37–1.59). Vascular and visual comorbidities were similarly associated with increased risks of moderate and severe visual disability. Conclusions: Visual and vascular comorbidities are associated with progression of visual disability in MS. Clinicians hearing reports of worsening visual symptoms in MS patients should consider visual comorbidities as contributing factors. Further study of these issues using objective, systematic neuro-ophthalmologic evaluations is warranted.

scholarly journals A Survey of Cannabis Use in a Large US-Based Cohort of People with Multiple Sclerosis

2021 ◽  
Vol 23 (6) ◽  
pp. 245-252
Author(s):  
Amber Salter ◽  
Robert J. Fox ◽  
Gary Cutter ◽  
Ruth Ann Marrie ◽  
Kate E. Nichol ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Sleep Problems ◽  
Safety Data ◽  
The United States ◽  
Cannabis Use ◽  
Future Research ◽  
Research Committee ◽  
The North ◽  
American Research ◽  
Lower Education

Abstract Background: As cannabis products become increasingly accessible across the United States, it is important to understand the contemporary use of cannabis for managing multiple sclerosis (MS) symptoms. Methods: We invited participants with MS from the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry (aged 18 years or older) to complete a supplemental survey on cannabis use between March and April 2020. Participants reported cannabis use, treated symptoms, patterns, preferences, methods of use, and the factors limiting use. Findings are reported using descriptive statistics. Results: Of the 6934 participants invited, 3249 responded. Of the respondents, 31% reported having ever used cannabis to treat MS symptoms, with 20% currently using cannabis. The remaining 69% had never used cannabis for MS symptoms, for reasons including not enough data about efficacy (40%) and safety (27%), and concerns about legality (25%) and cost (18%). The most common symptoms current users were attempting to treat were spasticity (80%), pain (69%), and sleep problems (61%). Ever users (vs never users) were more likely to be younger, be non-White, have lower education, reside in the Northeast and West, be unemployed, be younger at symptom onset, be currently smoking, and have higher levels of disability and MS-related symptoms (all P &lt; .001). Conclusions: Despite concerns about insufficient safety and efficacy data, legality, and cost, almost one-third of NARCOMS Registry respondents report having tried nonprescription cannabis products in an attempt to alleviate their symptoms. Given the lack of efficacy and safety data on such products, future research in this area is warranted.

Differences in Bladder Care for Veterans with Multiple Sclerosis by Treatment Location

2009 ◽  
Vol 11 (2) ◽  
pp. 91-97 ◽  
Author(s):  
Ruth Ann Marrie ◽  
Gary Cutter ◽  
Tuula Tyry ◽  
Denise Campagnolo ◽  
Timothy Vollmer
Keyword(s):  
Multiple Sclerosis ◽  
Multidisciplinary Care ◽  
Veterans Health ◽  
Health Administration ◽  
Research Committee ◽  
Urogenital Distress Inventory ◽  
The North ◽  
Bladder Management ◽  
American Research ◽  
Independent Association

Previous work suggested that veterans with multiple sclerosis (MS) treated through the Veterans Health Administration (VHA) had greater access to multidisciplinary care than veterans treated elsewhere. It is unknown whether other VHA-related differences in processes of MS care exist. Using the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry, we aimed to compare bladder management reported by veterans who receive care through the VHA (VHA veterans) and those who do not (non-VHA veterans). In 2005, NARCOMS participants completed the Urogenital Distress Inventory–6 (UDI-6) and reported urologic investigations and treatments. Using multivariable logistic regression, we assessed the independent association of VHA care with investigations or treatments. A total of 1247 veterans with MS responded to the questionnaire, of whom 1230 (98.6%) reported where they received their health care. Of these, 583 (47.4%) received some or all of their care through the VHA. After adjustment for demographic and clinical factors, VHA veterans more frequently reported undergoing urologic investigations than non-VHA veterans (adjusted odds ratio, 2.02; 95% confidence interval, 1.55–2.61). VHA veterans more frequently reported using pharmacologic and nonpharmacologic interventions than non-VHA veterans. Differences exist in the processes of MS bladder care between the VHA and elsewhere; this variation suggests the availability of opportunities to optimize such care.

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