ABSTRACT
Introduction: The experience of suffering multiple sclerosis (MS) can generate patient personal benefit gain and self-improvement. The global pandemic might play a role in the development of post-trauma growth, as patients can perceive the 2019 coronavirus (Covid-19) as a higher threat than the average due to MS condition. Objectives/Aims: To study possible changes in post-traumatic growth in people with MS and Covid-19 influence. Method(s): The sample comprised 260 participants (179 women and 81 men), receiving health care at Virgen Macarena University Hospital. Mean age was 45.05 years (SD= 10.61), from 19 to 78 years old. The MS type were Relapsing-Remitting (n=228) and Progressive (n=32), the Expanded Disability Status Scale (EDSS) mean score was 3.21 (SD=1.93), and mean MS duration was 144.77 months since diagnosis (SD=89.33). Post-traumatic growth inventory (PGI-21) was applied to evaluate patient perception of personal benefit on two different occasions: (T1) 2018- 2019 and, 18 months later, (T2) 2020-2021. At T2, Covid-19 influence was appraised asking patients if they felt affected or not about the Covid situation. Paired t-test examine changes in Post- Traumatic Growth between T1 and T2. Unpaired t-test tested differences in patients affected (n=123) and not affected (n=137) by Covid-19 at T2. Result(s): From T1 to T2 every subscale: relating to others, new possibilities, personal strength, spiritual change, appreciation of life, and PGI-21 total score significantly increased (p<0.0001 for all). Patients affected by Covid-19 reported significant higher scores of PGI-21 subscales and total scores than patients stated not to be affected by Covid-19. Conclusion(s): Patients showed an increase in post-traumatic growth over an 18 months follow-up period, this suggest that elaborating a post-trauma growth is a process that might require time. Additionally, patients who felt affected by Covid-19 presented higher scores in post-traumatic growth. Feeling in an adverse situation, as a global pandemic, might promote the personal benefit gain process in MS.
ABSTRACT
Background: Patients suffering from multiple sclerosis (MS) are at higher risk than the average for 2019 coronavirus (Covid-19). Therefore, the global pandemic can be a challenge for mental well-being in MS. Objective: To study longitudinal changes in mental health in adults with MS and Covid-19 impact. Methods: The sample was composed of 259 outpatients of Virgen Macarena University Hospital (179 women;80 men, ages 19-78 years old (mean 45.12 years, SD=10.57 years). At baseline, Relapsing-Remitting (n=227) and Progressive (n=32) MS type were reported. The Expanded Disability Status Scale (EDSS) mean score was 3.21 (SD=1.93) and mean MS duration was 144.92 months since diagnosis (SD=89.47). General Health Questionnaire-28 (GHQ-28) was used to assess Mental Health in three occasions separated by 18 months;(T1) 2017-2018, (T2) 2018-2019 and, (T3) 2020-2021. At T3, Covid-19 impact was measured with a five point Likert scale (from 1 to 5), higher score indicating greater impact. Changes in Mental Health among the three assessments were tested with the one-way repeated measures ANOVA. Unpaired t-test was applied to examine differences in mental health at T3 between patients affected and not affected by Covid-19. Spearman correlations between Covid-19 impact and mental health in affected patients were calculated. Results: From T1 to T2 somatic symptoms (p<0.0001), anxiety and insomnia (p=0.003), severe depression (p=0.016) subscales, and General GHQ-28 score (p=0.004) significantly decreased. On the contrary, from T2 to T3 these subscales increases, but just anxiety and insomnia subscale (p<0.0001) and General GHQ-28 score (p=0.011) presented significant levels. The social dysfunction subscale increased from T1 to T2 and decreased from T2 to T3, but did not reach statistical significance. GHQ-28 subscales and General GHQ-28 score were significantly higher in affected by Covid-19 patients (p<0.0001) and positively correlated with Covid-19 impact (p<0.05). Conclusions: Patients reported a first decrease in emotional distress symptoms follow by an increase. The first improvement in mental health suggests a possible adaptation to the disease in despite of disease progression. The association between the later deterioration and Covid-19 impact might indicate the emotional impact suffered by PwMS living in a global pandemic. Further longitudinal research is required to better understand Covid-19 influence on mental health evolution in MS.