Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Sep 5;3(3):2055217317728301.
doi: 10.1177/2055217317728301. eCollection 2017 Jul-Sep.

Which symptoms contribute the most to patients' perception of health in multiple sclerosis?

Rivka Green  1 , Gary Cutter  2 , Michael Friendly, Ilya Kister  3
Affiliations

Which symptoms contribute the most to patients' perception of health in multiple sclerosis?

Rivka Green et al. Mult Scler J Exp Transl Clin. .

Abstract

Background: Multiple sclerosis is a polysymptomatic disease. Little is known about relative contributions of the different multiple sclerosis symptoms to self-perception of health.

Objectives: To investigate the relationship between symptom severity in 11 domains affected by multiple sclerosis and self-rated health.

Methods: Multiple sclerosis patients in two multiple sclerosis centers assessed self-rated health with a validated instrument and symptom burden with symptoMScreen, a validated battery of Likert scales for 11 domains commonly affected by multiple sclerosis. Pearson correlations and multivariate linear regressions were used to investigate the relationship between symptoMScreen scores and self-rated health.

Results: Among 1865 multiple sclerosis outpatients (68% women, 78% with relapsing-remitting multiple sclerosis, mean age 46.38 ± 12.47 years, disease duration 13.43 ± 10.04 years), average self-rated health score was 2.30 ('moderate to good'). Symptom burden (composite symptoMScreen score) highly correlated with self-rated health (r = 0.68, P < 0.0001) as did each of the symptoMScreen domain subscores. In regression analysis, pain (t = 7.00), ambulation (t = 6.91), and fatigue (t = 5.85) contributed the highest amount of variance in self-rated health (P < 0.001).

Conclusions: Pain contributed the most to multiple sclerosis outpatients' perception of health, followed by gait dysfunction and fatigue. These findings suggest that 'invisible disability' may be more important to patients' sense of wellbeing than physical disability, and challenge the notion that physical disability should be the primary outcome measure in multiple sclerosis.

Keywords: Multiple sclerosis; disability; self-rated health; self-report; symptom.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Visual effects plots between each predictor and general health holding the other predictors constant.
See this image and copyright information in PMC

References

    1. Trojano M, Pellegrini F, Fuiani A, et al. New natural history of interferon-beta-treated relapsing multiple sclerosis. Ann Neurol 2007; 61: 300–306. - PubMed
    1. Constitution of the World Health Organization. In: World Health Organization. Handbook of basic documents, 5th ed. Geneva: Palais des Nations, 1952, pp. 3–20.
    1. Assari S. Gender differences in the predictive role of self-rated health on short-term risk of mortality among older adults. SAGE Open Med 2016; 4: 1–8. - PMC - PubMed
    1. Jones SL, Warren S, Turpin KVL, et al. The burden of multiple sclerosis: a community health survey. Health Qual Life Outcomes 2008; 6: 1. - PMC - PubMed
    1. Marck CH, Hadgkiss EJ, Weiland TJ, et al. Physical activity and associated levels of disability and quality of life in people with multiple sclerosis: a large international survey. BMC Neurol 2014; 14: 11. - PMC - PubMed

LinkOut - more resources