Symptom profiles of individuals with multiple sclerosis grouped by levels of social support.

TitleSymptom profiles of individuals with multiple sclerosis grouped by levels of social support.
Publication TypeConference Proceedings
Year of Conference2012
AuthorsJohnson KL, Amtmann D, Verrall A, Weir VG, Smith AE
Conference NameEuropean Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS)
Conference LocationLyon, France

Introduction:  Social support has been associated with quality of life for people with multiple sclerosis (MS).  Social support as a construct can represent both the adequacy of social relationships in patient's lives as well as a metric for socio-economic status or a social determinant of health that is shaped by wider forces connected to health disparities and inequalities.  The objective of this study was to examine symptom profiles including relative rates of pain, fatigue, physical and mental health, and psychological and cognitive functioning for individuals with MS grouped by high, medium, and low levels of social support.

Methods: PROMIS measures of depression, anxiety, fatigue, pain, sleep disturbance, wake disturbance, physical ability and Neuro-QoL measures of general and executive cognitive function were completed by 613 community-dwelling individuals with MS as part of a longitudinal survey (2008 - 2009).  Scores were compared to US population norms by tertiles of the Multidimensional Scale of Perceived Social Support (MSPSS) low (N=209), medium (N=204) and high (N=200).

Results: Our data suggest an inverse relationship between symptom burden and social support.  The low social support group reported higher levels of symptom burden on all measures as compared to the population norm (p < 0.001).  The high social support group exhibited sleep and wake disturbance that were no different from the population norm (p > 0.05) and actually a reduction in anxiety and depression scores in contrast to the population norm (p < 0.001).  In addition, we examined symptom burden by levels of self-efficacy with respect to MS management, which also revealed a similar pattern to social support (inverse relationship).

Conclusions: The striking finding that respondents who reported low levels of social support and low levels of MS Self Efficacy, reported high levels of emotional distress and overall symptom burden has clinical implications.  It seems unlikely that addressing individual symptoms will result in significant change for individuals and that rather interdisciplinary interventions need be individualized and target multiple variables.

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