Perceived stress and social support in a large population of people with multiple sclerosis recruited online through the COVID‐19 pandemic

Abstract

Background and purpose:The COVID-19 emergency may cause post-traumatic stress disorder (PTSD), and with regard to people with MS (pwMS) chronic exposure to a wide range of challenging life events has been shown to be correlated with worsening of neurological symptoms, increased lesion burden on brain magnetic resonance imaging and relapses. The aim was to investigate perceived stress, depression, perceived social support, habits and behaviour changes in pwMS through COVID-19 in comparison to a control group. Methods:A web-based survey was posted on SMsocialnetwork.com to investigate perceived stress (using the Perceived Stress Scale), depression (with Patient Health Questionnaire 2) and perceived social support (using Social Provision Scale 10 item) in pwMS and a control group through the COVID-19 pandemic. A secondary group of people with migraine was investigated.Results: In all, 1286 answers from 612 pwMS and 674 control people were included in the final analysis. The answers from 318 people with migraine were included for a secondary analysis. A higher proportion of pwMS were depressed (43.1% vs. 23.1%; p < 0.001), had a high level of perceived stress (58% vs. 39.8%; p < 0.001) and felt significantly less social support (median 33 vs. 35; Q1-Q3 28-36 vs. 32-37; p < 0.001) compared to the control group. A higher percentage of people with migraine were depressed (50% vs. 43%, p = 0.04) compared to pwMS. Conclusions:Considering the negative impact that prolonged stress may have on clinical and radiological disease activity of pwMS, and bearing in mind that a beneficial effect has been demonstrated and achieved with stress management, it is suggested to promote stress control in these patients during the COVID-19 pandemic.

Coping with stress during the first wave of the COVID-19 pandemic by Turkish people with Multiple Sclerosis: The relationship between perceived stress and quality of life

“…Both depression and anxiety were elevated above the rates observed in the general population, but only marginally above typical levels for the MS population relative to prior studies. On the other hand, in a study conducted on pwMS during pandemic indicated increased perceived stress compared with healthy controls but in the same study, it has been observed that people with migraine were more stressful than pwMS ( Bonavita et al., 2020 ). In our study group, the perceived stress level was found to be high only in 11.0% and perceived stress was not associated with many factors such as gender, age, marital status, education level, employment status, disease duration, disability and income level.…”

COVID-19 and the Risk of Relapse in Multiple Sclerosis Patients: A Fight with No Bystander Effect?

“…Whether or not chronic stress predisposes MS patients to higher risks of developing relapses is controversial, partly due to the inter-study differences in terms of stress definition and measurement methods (Xie et al, 2020). However, we speculate that this evident psychological stress on RRMS patients (Stojanov et al, 2020, Bonavita et al, 2020 may have had an impact, at least partially, on the activity of their disease during this period, and it was more significant in patients who had not contracted COVID-19 during those times, probably facing chronically elevated levels of stress during the 9-10 months recorded in our study.…”

“…Recently, Bonavita et al have surveyed a large number of MS patients to assess perceived stress, depression, and perceived social support. Unfortunately, a significantly higher proportions of MS patients, compared to healthy controls, were depressed (43.1% vs. 23.1%; p<0.001), experienced high levels of stress (58% vs. 39.8%; p<0.001), and less perceived social support (p<0.001) (Bonavita et al, 2020). These patients may experience high levels of chronic stress because of the pandemic, their clinical condition, and their immunosuppressive treatment regimens.…”

“If You Can’t Control the Wind, Adjust Your Sail”: Tips for Post-Pandemic Benefit Finding from Young Adults Living with Multiple Sclerosis. A Qualitative Study

“…The psychological impact of COVID-19 in terms of stress, negative emotional reactions (e.g., anxiety, depression), and traumatic responses has been extensively studied in the general population [39] and to a lower extent also in vulnerable populations, such as chronically ill patients, including patients with MS [15,[17][18][19][20][21][22][23]. Moreover, young adults are particularly vulnerable and at greater risk of developing adverse psychological symptoms during the pandemic, as demonstrated in a study by Forte and colleagues [40] that focused on people under the age of 50.…”

“…Despite these challenges that would suggest a greater risk for developing negative emotional responses [16], studies exploring the psychological reaction of patients with MS found mixed results. Some studies highlighted high levels of anxiety [17,18] perceived stress [19] and depression [15,[18][19][20][21] while others did not find any worsening of emotional distress and also an improvement in some areas of quality of life [22,23]. Indeed, although further studies with larger samples are needed, it can be hypothesized that patients with MS managed to maintain an adequate level of wellbeing.…”