Perceived discrimination in patients with multiple sclerosis and depressive symptomatology

Mult Scler Relat Disord. 2021 Feb:48:102705. doi: 10.1016/j.msard.2020.102705. Epub 2020 Dec 28.

Abstract

Background: Multiple Sclerosis is the central nervous system's most common demyelinating disease and the second leading cause of neurological disability in young adults. Its natural development involves physical and cognitive impairment. Patients commonly perceive discrimination against them, regardless of its occurrence, accepting it as an inherent part of the disease.

Objective: This study aimed to determine the association between perceived discrimination and the depressive symptoms and physical disability present in patients diagnosed with multiple sclerosis, treated at the Demyelinating Diseases Clinic of the National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez.

Methods: A cross-sectional study was conducted in 98 patients diagnosed with multiple sclerosis. Demographic and clinical variables were obtained through clinical interviews. The severity of the disease was determined using the Extended Disability Status Scale (EDSS), depressive symptoms were assessed with the Beck Depression Inventory (BDI), and perceived discrimination was rated using the King Internalized Stigma Scale.

Results: The studied sample's mean age was 36.3 years, schooling 13.6 years, symptoms onset was at 26.2 years (with a delay in diagnosis of 3.2 years), and a disease evolution of 10.9 years. 71.4% were single; 52% had an unpaid work activity and 57.1% were women. The EDSS average was 3.5 points; 24.5% presented moderate to severe depressive symptoms and 53.1% referred perceived discrimination.

Conclusions: Perceived discrimination in patients with multiple sclerosis was associated with earlier disease onset, depressive symptoms, and the lack of caregivers. Medical care and life quality improvement for this vulnerable group require greater education regarding the disease and the establishment of patient support programs.

Keywords: Definite multiple sclerosis; Depressive disorder; EDSS; Social discrimination; Social stigma.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Depression
  • Disabled Persons*
  • Female
  • Humans
  • Male
  • Multiple Sclerosis* / complications
  • Multiple Sclerosis* / epidemiology
  • Psychiatric Status Rating Scales
  • Young Adult