Psychiatric and physical comorbidities and pain in patients with multiple sclerosis

Abstract

BackgroundIt has been observed that patients with multiple sclerosis (MS), who have psychiatric and physical comorbidities such as depression and COPD, have an increased risk of experiencing more pain. In this study, we have distinguished between pain intensity and pain affect, as the latter, particularly, requires treatment. Furthermore, while pain and comorbidities have been assessed using questionnaires, this is possibly a less reliable method for those who are cognitively vulnerable.ObjectiveThe aim of this study was to determine whether psychiatric and physical comorbidities can predict pain intensity and pain affect in MS patients, susceptible to cognitive impairment.MethodsNinety-four patients with MS and 80 control participants participated in this cross-sectional study. Besides depression and anxiety, 47 additional comorbidities were extracted from patients’ medical records. Depression and anxiety were assessed using the Beck Depression Inventory and the Symptom Check List-90. Pain was assessed using the Number of Words Chosen Affective, Coloured Analog Scale, and the Faces Pain Scale. Cognitive functions, for example, memory and executive functions, were assessed using several neuropsychological tests.ResultsThe main findings indicate that psychiatric comorbidities (depression and anxiety) predict both pain intensity and pain affect and that total physical comorbidity predicts only pain affect in MS patients, susceptible to cognitive impairment.ConclusionBoth psychiatric and physical comorbidities predict pain affect. All three clinical outcomes enhance MS patients’ suffering.

Sensory Function and Chronic Pain in Multiple Sclerosis

“…The present cross-sectional study was part of a larger study examining the relationship between pain and cognition in patients with multiple sclerosis [ 16 , 17 ].…”

“…Comorbidities that might cause sensory disturbances, that is, diabetes, transient ischemic attack (TIA), migraine, and epilepsy, were listed (for a full list of comorbidities see [ 17 ]).…”

Treatment Optimization in Multiple Sclerosis: Canadian MS Working Group Recommendations

“…Medical and psychiatric comorbidities are highly prevalent in the MS population 65 and may be associated with relapses, worsening disability, and poorer quality of life. [66][67][68][69] The presence of comorbid conditions will also be an important consideration during treatment selection and optimization. Clinicians need to work in collaboration with other healthcare providers, including the patient's family physician, to ensure that other medical conditions are being adequately managed.…”

<p>Comorbidities in multiple sclerosis—a plea for interdisciplinary collaboration to improve the quality of life of MS patients</p>

“…Frequent comorbidities include hyperlipidemia in MS, so simvastatin treatment as part of personalized medicine could significantly improve quality of life in PwMS with both conditions in the long-term. Psychiatric CM (depression and anxiety) and physical CM as well as pain are closely related and increase the suffering of PwMS 63…”