The Psychological Impact of COVID-19 Pandemic on People With Multiple Sclerosis

Abstract

The coronavirus disease 2019 has radically changed the world in a few weeks. Italy has been one of the first and most affected countries with more than 30,000 deaths up to now. Public health measures as quarantine or national lockdown are necessary to limit the spread of infectious diseases, but it is unsurprising that depriving people of their liberty has negative psychological effects. This is especially the case for people with chronic diseases, including neurological conditions like multiple sclerosis (MS). People with MS (PwMS) have a higher burden of neuropsychiatric comorbidities and are known to undertake maladaptive coping strategies in stress conditions. The aim of the present study is to investigate the impact of COVID-19 pandemic lockdown on mental health of an Italian cohort of PwMS in comparison with healthy controls (HCs).Methods: A total of 60 PwMS and 50 HCs (chosen among patients' cohabitants) were asked to answer a Web-based survey. This survey inquired about the impact of COVID-19 on patient's quality of life, job, and daily routine. Mood, fatigue, and sleep quality were evaluated using the Beck Depression Inventory II (BDI-II), the Generalized Anxiety Disease 7 (GAD-7), the Fatigue Severity Scale (FSS), and the Pittsburgh Sleep Quality Index (PSQI).Results: Overall, patients had higher scores of BDI, FSS, and PSQI, and these differences were statistically significant (p < 0.05). When we looked at the subscores of the BDI, we detected a statistically significant difference for the neurovegetative part-that concerns with sleep, appetite, sex, and quality of sleep (p < 0.05). One out of five patients reported new symptoms or worsening of known symptom, in particular, sensory disturbances, and fatigue. However, no symptoms were severe enough to require hospitalization. When we looked for correlations among variables, we found that there was a significant relationship between unemployment and BDI total score, GAD-7, and PSQI in MS group. The presence of new symptoms or the worsening of symptoms positively related to FSS and to PSQI.Discussion: We identified that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic had a significant impact on the psychological status of patients with MS. Compared with the general population, PwMS presented a higher burden of Motolese et al.COVID-19 Psychological Impact on PwMS depressive symptoms, a worse sleep quality and perceived an increase in fatigue level, one of the most disabling symptoms of MS. The COVID-19 epidemic poses a challenge to psychological resilience. More studies are warranted to better understand the long-term consequences of the pandemic on mental health of vulnerable people during the disease outbreaks.

Fear of COVID-19, problems accessing medical appointments, and subjective experience of disease progression, predict anxiety and depression reactions in patients with Multiple Sclerosis

“…Overall, there are recent studies that have also revealed a negative mental health impact in PwMS that have not tested positive during the current pandemic. These studies found a higher prevalence of depression and anxiety than usual ( Motolese et al, 2020 ; Talaat et al, 2020 ).…”

“…In Multiple Sclerosis (MS), there are studies suggesting a negative impact of this pandemic on the mental health of patients with MS (PwMS). For example, a study done in Italy explored how the lockdown period impacted on the mental health of patients in comparison with healthy controls ( Motolese et al, 2020 ). The authors reported that, MS patients, compared with the general population, presented a higher burden of depressive symptoms, a worse sleep quality and perceived an increase in fatigue level.…”

“…This DMTs cause significant immune suppression ( Giovannoni et al, 2020 ), which can increase the fear of getting sick. In addition, measures of physical distancing can be an obstacle for patients to attend cognitive and physical rehabilitation ( Motolese et al, 2020 ) and if patients do not attend these services the levels of psychological distress may increase.…”

Review of the COVID-19 Risk in Multiple Sclerosis

“…The ongoing COVID-19 pandemic has created a lot of anxiety among MS patients, their families and physicians who care for patients with MS. In comparison to the general population, MS patients have had higher rates of depression, worse sleep quality, and fatigue during the pandemic [ 91 ]. Additionally, many MS patients are concerned about their DMT-regimens during the pandemic and some have even stopped it [ 92 ].…”

“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.…”