Quality of life in 188 patients with myasthenia gravis in China

Abstract

Myasthenia gravis (MG) is a kind of chronic autoimmune disease which can weaken patients' motor function and, furthermore, produce negative impact on the health-related quality of life (HRQoL). The primary purpose of this research was to evaluate factors that might affect the HRQoL of MG patients. A cross-sectional clinical research was carried out including 188 successive patients with MG. Myasthenia Gravis Foundation of America (MGFA) classification and Quantitative Myasthenia Gravis (QMG) score were applied to assess the severity of the disease. The Medical Outcome Survey 36-Item Short-Form Health Survey (SF-36) was used to estimate the HRQoL. Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scale (HARS) were utilized to measure the depression and anxiety symptom. Factors may influence the HRQoL of MG patients include age, educational level, occupation, the situation of the thymus, the type of MG and generalized myasthenia gravis (GMG), the severity of the disease and the psychological disorder. Higher QMG and HARS scores were two significant factors that can prognosticate lower Physical Composite Score (PCS) and Mental Composite Score (MCS), while older age was just a significant factor which has prognostic value for lower PCS. The results of this research may have a potential guiding significance for the clinical treatment strategy and improve the quality of life in patients with MG consequently. In addition to the treatment of physical symptoms, the psychological symptoms such as anxiety and depression should be concerned as well.

Factors associated with quality of life of people with Myasthenia Gravis

“…Considering the interferences of daily functioning due to the symptoms of MG, heightened depression and lowered quality of life (QOL) are not unanticipated [ 4 – 12 ]. Disease’s severity [ 4 ], lower education [ 5 ], older age [ 5 – 6 ], being woman [ 7 ], as well as lower social support [ 5 ] were positively correlated with patient’s physical health [ 4 – 7 ], while being optimistic, positive thinking, and sense of humor functioned as protective factors [ 8 ] for a better QOL.…”

Quality of life in refractory generalized myasthenia gravis: A rapid review of the literature

“…As a result of the search, 9 cross-sectional studies were identified that assessed the quality of life of patients with GMG; however, no specific evidence was identified for the subtype of refractory GMG. In most of the included studies, comparisons are made between different types of MG, identifying a greater impact on the quality of life in GMG versus ocular MG and MG in remission (10,13,14). The differences are especially found in the domains of physical function, physical role, bodily pain, vitality and social function (13).…”

“…In most of the included studies, comparisons are made between different types of MG, identifying a greater impact on the quality of life in GMG versus ocular MG and MG in remission (10,13,14). The differences are especially found in the domains of physical function, physical role, bodily pain, vitality and social function (13). The connection of the domains of quality of life may be related to that found by Oosterhuis H, in his study of the natural course of MG in 1989, in which he noted that when GMG is associated with predominant bulbar muscle weakness, it results in severe restrictions in the activities of daily life and, when severe, it can cause myasthenic crises or require respiratory assistance (23).…”

Depressive Syndromes in Autoimmune Disorders of the Nervous System: Prevalence, Etiology, and Influence

“…Significant research into the HRQL of MG has documented that psychosocial disorders, predominantly anxiety and depression, are negatively correlated with HRQL, based on multivariate linear regression analysis, apart from significant demographic predicators (older age and lower education) and the current status of myasthenia gravis. Interestingly, the Hamilton Anxiety Rating Scale was verified as a more significant prediction factor for a lower quality of life in both physical and mental aspects than the Hamilton Depression Rating Scale ( 80 – 82 ). Similarly, Shi's research demonstrated that anxiety, disability, fatigue and depression were independent predictors of poor HRQL in NMOSD, and that anxiety was the best predictor of both the global and physical composite scores of HRQL, followed by disability, fatigue and depression (global composite, r 2 = 0.76, P = 0.000; physical composite, r 2 = 0.71, P = 0.000) ( 32 ).…”