Psychiatric comorbidities and suicidality among patients with neuromyelitis optica spectrum disorders in Argentina

Fernández, Victoria; Alonso, N.; Melamud, Luciana; Villa, Andrés

doi:10.1016/j.msard.2017.11.002

Cited by 22 publications

(20 citation statements)

References 12 publications

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“…In this study, cognition impairment, fatigue, and pain were reported by 40.7, 62.6, and 46.3%, respectively, throughout the course of the disease. Similar to these findings, previous studies reported that more than half of patients with NMOSD suffered from the above symptoms in different regions among different ethnicities (12,16,37,38). To be noted, 76.4% of patients reported suffering from negative emotions in our current study.…”

Section: Discussionsupporting

confidence: 91%

“…These differences in findings indicate that although NMOSD causes severe neurological dysfunctions, the psychological resilience of patients may be differentiated between ethnicities with different genetic and environmental backgrounds. Notably, the physical and emotional disorders of patients with NMOSD often lead to certain high-risk behaviors, such as self-harm and suicide ( 16 ). A more recent study exploring mortality and causes of death among 569 Chinese patients with NMOSD indicated that 8.3% of patients died due to suicide during a 10-year follow-up ( 17 ).…”

Section: Introductionmentioning

confidence: 99%

“…A more recent study exploring mortality and causes of death among 569 Chinese patients with NMOSD indicated that 8.3% of patients died due to suicide during a 10-year follow-up ( 17 ). Another study that evaluated the psychopathological profile and suicidality in an Argentinean NMOSD cohort illustrated that the prevalence of psychiatric disease was 45%, with 30% of patients attempting suicide at least once ( 16 ). Therefore, a comprehensive assessment of patients' physical and emotional conditions in certain regions or ethnicities is necessary to propose region-specific management to improve the quality of life for patients and reduce the incidence of high-risk behaviors.…”

Section: Introductionmentioning

confidence: 99%

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Physical, Emotional, Medical, and Socioeconomic Status of Patients With NMOSD: A Cross-Sectional Survey of 123 Cases From a Single Center in North China

et al. 2021

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Objective: This study aimed to assess the physical, emotional, medical, and socioeconomic conditions of patients with neuromyelitis optica spectrum disorder (NMOSD) in North China.Methods: A cross-sectional survey of patients with NMOSD was performed, based on an established questionnaire from the Multiple Sclerosis Patient Survival Report 2018. Logistic regression analysis was conducted to define the significant determinants of certain physical or emotional characteristics of patients. A total of 123 patients were included.Results: A total of 63.4% of participants were initially diagnosed with conditions other than NMOSD, with a median delay of 6 months for accurate diagnosis. An aggregate of 72.2% of patients had one or more relapses, corresponding to an annual relapse rate of 0.8. Paresthesia was the most frequent physical symptom among patients both at disease onset (53.7%) and throughout the duration of the disease (86.2%). Onset in elderly (>50 years) patients was associated with an annual Expanded Disability Status Scale increase ≥1, compared with onset in younger (<30 years) patients (P = 0.001, OR = 7.83). A total of 76.4% of patients had received attack-prevention treatments in the remission phase, and 31.7 and 10.6% of patients had ever been administered rituximab and traditional Chinese medicine, respectively. Additionally, 63.4 and 43.1% of patients reported participating in few or no social activities and being out of work because of the disease. To be noted, 76.4% of patients reported suffering from negative emotions, with the most frequent being worry (60.2%), with 20.3% of patients experiencing suicidal thoughts. The inability to work and participating in few or no social activities due to NMOSD were two determinants of experiencing negative emotions (Pwork = 0.03, ORwork = 3.34; Psocialactivities = 0.02, ORsocialactivities = 3.19).Conclusion: This study reported patient perspectives on NMOSD in North China, whereby demonstrating that the inability to work and participating in few or no social activities due to NMOSD rather than the physical impairment caused by the disease, was directly associated with patients experiencing negative emotions. This insight offers potential ways to manage patients' negative emotions by enhancing family and social support and facilitating active employment.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Physical, Emotional, Medical, and Socioeconomic Status of Patients With NMOSD: A Cross-Sectional Survey of 123 Cases From a Single Center in North China

et al. 2021

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“…More than 44% of patients experienced depression, although most cases were mild, and remarkably no patients scored within the severe category. Our prevalence and severity were lower than in studies measuring depression prevalence among NMOSD in Argentina, the USA, and Germany [ 34 , 36 , 37 ]; however, pain and disability were higher in these cohorts, and ethnicity also differed. It should be noted that our results on depression were similar to those reported by Yalachkov et al, as both populations had similar disease duration, low physical disability, and the same questionnaire was used, although the fast screen BDI questionnaire was used in our sample [ 15 ].…”

Section: Discussioncontrasting

confidence: 89%

Impact of Neuromyelitis Optica Spectrum Disorder on Quality of Life from the Patients’ Perspective: An Observational Cross-Sectional Study

et al. 2022

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Introduction Neuromyelitis optica spectrum disorder (NMOSD) is associated with a reduced health-related quality of life (HRQoL). The purpose of this study was to describe the impact of NMOSD on HRQoL from the patients’ perspective and its relationship with other disease factors. Methods An observational, cross-sectional study was conducted at 13 neuroimmunology clinics in Spain. Patients with NMOSD diagnosis (2015 Wingerchuk criteria) were included. The 29-item Multiple Sclerosis Impact Scale (MSIS-29) was used to assess the HRQoL. Different questionnaires were used to measure symptom severity, stigma, mood disorders, pain, fatigue, and difficulties in the workplace. Factors that impact HRQoL were identified by Spearman’s correlation and multivariate linear regression analysis. Results Seventy-one patients were included (mean age 47.4 ± 14.9 years, 80.3% female, mean time since disease onset 9.9 ± 8.1 years). The median Expanded Disability Status Scale score was 3.0 (1.5–4.5). The mean (± SD) physical and psychological MSIS-29 sub-scores were 41.9 ± 16.8 and 20.9 ± 8.3, respectively. Fatigue and body pain were the most prevalent symptoms. Depressive symptoms were found in 44.3% ( n = 31) of patients. The physical MSIS-29 dimension showed the highest correlation with symptom severity ( ρ = 0.85584, p < 0.0001), whereas the highest correlations for psychological MSIS-29 dimension were pain, MSIS-29 physical dimension, and depression ( ρ = 0.76487, 0.72779, 0.71380; p < 0.0001, respectively). Pain was a predictor of both dimensions of MSIS-29. Conclusion Fatigue, pain, and depressive symptoms are frequent problems among patients with NMOSD, impacting on their quality of life. Assessment of patient-oriented outcomes may be useful to achieve a holistic approach, allowing early specific interventions.

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“…Based on a retrospective analysis of a US administrative claims database, the prevalence of depression in patients with NMO (n=1,349) and highly active NMO (n=134; defined as at least two relapses within twelve months of the patient's first NMO encounter in the database) was estimated at 17.9% and 25.4%, respectively. 34 Fernandez et al found that ten patients with NMOSD (50%) had current depressive symptoms versus five (28%) patients with MS (p=0.16). 35 Six (30%) patients with NMOSD versus only one (5.5%) patient with MS had attempted suicide at least once (p=0.05).…”

Section: Discussionmentioning

confidence: 97%

Perception of Stigma in Patients with Neuromyelitis Optica Spectrum Disorder

Meca-Lallana¹,

Prefasi²,

Pérez‐Miralles³

et al. 2021

PPA

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Background Perception of stigma was associated with low self-esteem, psychological problems, and decreased health-seeking behavior among patients with different neurological disorders. The purpose of this study was to assess stigmatization and its impact in patients with neuromyelitis optica spectrum disorder (NMOSD). Methods A non-interventional study was conducted at thirteen neuroimmunology clinics in Spain. Patients with a diagnosis of NMOSD (2015 Wingerchuk criteria) were included. The 8-item Stigma Scale for Chronic Illness (SSCI-8), the Expanded Disability Status Scale (EDSS), the 29-item Multiple Sclerosis Impact Scale (MSIS-29), the Beck Depression Inventory-Fast Screen (BDI-FS), the MOS Pain Effects Scale (MOS-PES) and the Fatigue Impact Scale for Daily Use (D-FIS) were used to assess the perception of stigma, disability, quality of life, mood, pain, and fatigue, respectively. Associations between outcome measures were analyzed using Spearman’s rank correlation. Results Seventy-one patients were studied (mean age: 47.4 years ± 14.9, 81.7% female, mean time since disease onset: 9.9 years ± 8.1). The median EDSS score was 3.0 (interquartile range 1.5, 4.5). Stigma prevalence was 61.4% (n=43). Thirty-one patients (43.6%) had depression. The SSCI-8 score showed a significant correlation with both physical (rho=0.576, p<0.0001) and psychological (rho=0.608, p<0.0001) MSIS-29 scales scores, EDSS score (rho=0.349, p=0.0033), BDI-FS score (rho= 0.613, p<0.0001), MOS-PES score (rho= 0.457, p<0.0001), and D-FIS score (rho=0.556, p<0.0001). Conclusion Stigma is a common phenomenon affecting over 6 out of 10 patients with NMOSD. Understanding stigma may be useful to develop educational strategies improving NMOSD knowledge.

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Psychiatric comorbidities and suicidality among patients with neuromyelitis optica spectrum disorders in Argentina

Cited by 22 publications

References 12 publications

Physical, Emotional, Medical, and Socioeconomic Status of Patients With NMOSD: A Cross-Sectional Survey of 123 Cases From a Single Center in North China

Physical, Emotional, Medical, and Socioeconomic Status of Patients With NMOSD: A Cross-Sectional Survey of 123 Cases From a Single Center in North China

Impact of Neuromyelitis Optica Spectrum Disorder on Quality of Life from the Patients’ Perspective: An Observational Cross-Sectional Study

Perception of Stigma in Patients with Neuromyelitis Optica Spectrum Disorder

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