Impact of anger on the health-related quality of life of multiple sclerosis patients

Mult Scler. 2015 Apr;21(5):630-41. doi: 10.1177/1352458514549399. Epub 2014 Nov 28.


Background: There is evidence of the presence of a disturbed pattern of anger in multiple sclerosis (MS). Emotion changes, including anger, are thought to influence health-related quality of life (HRQoL). However, although deleterious consequences of anger on physical health have been well reported, there are no studies that have analysed the effects of anger on the HRQoL in patients with MS. Our purpose was to assess the extent to which anger impacts on the HRQoL of a cohort of MS patients.

Methods: One hundred and fifty-seven consecutive MS patients were enrolled in the study. Participants were administered affective trait measures (Beck Depression Inventory, Beck Anxiety Inventory) and anger measures (the Spanish adapted version of the State-Trait Anger Expression Inventory-2). HRQoL was quantified using the Functional Assessment of MS.

Results: Linear regression analyses revealed that even after controlling for socio-demographic and clinical variables, higher levels of anger expression-in (tendency to handle anger by keeping it inside) independently predicted worse overall HRQoL of MS patients (β = -0.15, p = 0.04). We further found that this relationship was moderated by gender, showing that anger expression-in is a more influential predictor of the HRQoL in women with MS.

Conclusion: The present study provides evidence that anger negatively affects the HRQoL of MS patients. Our results may have implications for those involved in treating emotional complications of MS and especially regarding psychotherapeutic interventions to improve HRQoL of MS patients.

Keywords: Anger; health-related quality of life; multiple sclerosis; neuropsychiatric; non-motor features.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anger*
  • Anxiety / psychology
  • Cohort Studies
  • Depression / psychology
  • Emotions
  • Fatigue / etiology
  • Fatigue / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / psychology*
  • Neuropsychological Tests
  • Psychiatric Status Rating Scales
  • Quality of Life
  • Socioeconomic Factors