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. 2023 Jun 14:17:1431-1439.
doi: 10.2147/PPA.S411069. eCollection 2023.

Hopelessness in Patients with Early-Stage Relapsing-Remitting Multiple Sclerosis

Susana Sainz de la Maza  1 , Jorge Maurino  2 , Tamara Castillo-Triviño  3 , Mónica Borges  4 , Berta Sebastián Torres  5 , Javier Sotoca  6 , Ana María Alonso Torres  7 , Ana B Caminero  8 , Laura Borrega  9 , José L Sánchez-Menoyo  10 , Francisco J Barrero-Hernández  11 , Carmen Calles  12 , Luis Brieva  13 , María Rosario Blasco  14 , Julio Dotor García-Soto  4 , Ana Rodríguez-Regal  15 , Laura Navarro-Cantó  16 , Eduardo Agüera-Morales  17 , Moisés Garcés  18 , Olga Carmona  19 , Laura Gabaldón-Torres  20 , Lucía Forero  21 , Mariona Hervás  22 , Rocío Gómez-Ballesteros  2
Affiliations

Hopelessness in Patients with Early-Stage Relapsing-Remitting Multiple Sclerosis

Susana Sainz de la Maza et al. Patient Prefer Adherence. .

Abstract

Background: Hopelessness is a risk factor for depression and suicide. There is little information on this phenomenon among patients with relapsing-remitting multiple sclerosis (RRMS), one of the most common causes of disability and loss of autonomy in young adults. The aim of this study was to assess state hopelessness and its associated factors in early-stage RRMS.

Methods: A multicenter, non-interventional study was conducted. Adult patients with a diagnosis of RRMS, a disease duration ≤ 3 years, and an Expanded Disability Status Scale (EDSS) score of 0-5.5 were included. The State-Trait Hopelessness Scale (STHS) was used to measure patients´ hopelessness. A battery of patient-reported and clinician-rated measurements was used to assess clinical status. A multivariate logistic regression analysis was conducted to determine the association between patients' characteristics and state hopelessness.

Results: A total of 189 patients were included. Mean age (standard deviation-SD) was 36.1 (9.4) years and 71.4% were female. Median disease duration (interquartile range-IQR) was 1.4 (0.7, 2.1) years. Symptom severity and disability were low with a median EDSS (IQR) score of 1.0 (0, 2.0). A proportion of 65.6% (n=124) of patients reported moderate-to-severe hopelessness. Hopelessness was associated with older age (p=0.035), depressive symptoms (p=<0.001), a threatening illness perception (p=0.001), and psychological and cognitive barriers to workplace performance (p=0.029) in the multivariate analysis after adjustment for confounders.

Conclusion: Hopelessness was a common phenomenon in early-stage RRMS, even in a population with low physical disability. Identifying factors associated with hopelessness may be critical for implementing preventive strategies helping patients to adapt to the new situation and cope with the disease in the long term.

Keywords: depressive symptoms; hopelessness; relapsing-remitting multiple sclerosis; suicide; workplace difficulties.

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Conflict of interest statement

Susana Sainz de la Maza received payment for lecturing or travel expenses from Merck, Biogen, Sanofi- Genzyme, Roche, and Novartis. Ana María Alonso Torres received compensation for consulting services from Biogen, BMS, Sanofi, Roche, Janssen and Novartis; and speaking honoraria from Biogen, BMS, Sanofi, Roche, Janssen, Merck, Almirall and Novartis. Ana B Caminero received courses and honoraria for her participation as speaker/meeting moderator/symposia organizer from Alter, Almirall, Bayer, Bial, Biogen, Bristol-Myers-Squibb, Lilly, Merck, Mylan, Novartis, Roche, Sanofi-Genzyme, Teva and UCB; and support to attend scientific meetings from Biogen, Bial, Merck-Serono, Novartis, Roche, Sanofi-Genzyme and Teva. Laura Borrega received compensation for consulting services, speaking honoraria and support to attend scientific meetings from Bayer, Celgene, Biogen, Genzyme, Merck, Novartis, Roche, Almirall and Teva. José L Sánchez-Menoyo received support to attend scientific meetings from Novartis, Merck, and Biogen; speaking honoraria from Biogen, Novartis, Sanofi, Merck, Almirall, Bayer and Teva; and participated in clinical trials from Biogen, Merck, and Roche. Francisco J Barrero-Hernández received compensation for consulting services and speaking honoraria from Almirall, Biogen, Genzyme, Merck, Novartis, Roche, Sanofi and Teva. Carmen Calles received compensation for consulting services, speaking honoraria and support to attend scientific meetings and courses from Merck, Teva, Sanofi-Genzyme, Novartis, Biogen, Roche, and Bristol-Myers-Squibb. Julio Dotor García-Soto received compensation for consulting services and speaking honoraria from Biogen, Novartis, Merck, UCB, Sanofi-Genzyme, Roche, Almirall and Teva. Laura Navarro-Cantó received compensations from Sanofi-Genzyme, Merk, Biogen and Roche. Eduardo Agüera-Morales received speaking honoraria from Roche, Novartis, Merck, Sanofi and Biogen. Moisés Garcés has received speaking honoraria from Biogen, Sanofi, Almirall and Novartis. Laura Gabaldón-Torres received speaking honoraria from Biogen, Novartis, Merck, Bayer, Sanofi-Genzyme, Almirall, Roche and Teva. Mariona Hervás participated in observational studies and received compensation for consulting services and speaking honoraria from Roche, Merck, Sanofi, Biogen, Novartis and Bayer. Jorge Maurino and Rocío Gómez-Ballesteros are employees of Roche Farma Spain. Tamara Castillo-Triviño reports personal fees from Almirall, Biogen, Bristol Myers Squibb, Janssen, Merck, Novartis, Roche, and Sanofi-Genzyme, outside the submitted work. The rest of the authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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