DEPRESSION IN MULTIPLE SCLEROSIS AS A FUNCTION OF LENGTH AND SEVERITY OF ILLNESS, AGE, REMISSIONS, AND PERCEIVED SOCIAL SUPPORT
The purpose of this study was to examine objectively the relationship between depression severity and various illness, demographic and social variables in patients suffering from the spinal form of Multiple Sclerosis (MS). The predictions were made that patients with a shorter length of illness would be more depressed, that the more disabled patients would have a more severe depression, that older patients would tend to be more depressed, that patients who perceived the presence of social support would be less depressed, and finally, that patients who had experienced remissions would be less depressed. There were 120 subjects who were seen as outpatients at the Multiple Sclerosis Comprehensive Care Center at Albert Einstein College of Medicine and Hospital, Bronx, New York. The subjects were initially screened for intellectual competence using the Vocabulary subtest of the WAIS. The dependent variable, depression, was measured by the Beck Depression Inventory. The independent variables were assessed by interview, the Kurtzke Disability Status Scale for MS, and the Perceived Social Support Inventory. Length of illness in the present study was not found to be significantly correlated with depression severity. A significant positive relationship was discovered between depression and degree of disability. Older subjects were likewise found to be significantly more depressed than younger subjects. Those who had experienced at least one remission were less depressed than those who had never had a remission. The most highly significant correlation was found between depression severity and perceived social support. A forward stepwise multiple regression analysis revealed that prediction of depression severity in spinal MS patients would be aided most by examination of perceived social support systems, disability severity, and course of illness. The variables of age and length of illness add little to predictive power. Although the methods of psychological research with MS patients have been in the past generally of questionable validity and rather contradictory, there have been some studies that employed more objective and valid measures such as the MMPI. The results of the present study were consistent with several of these investigations that examined age, course of illness, and disability severity in regard to depth of depression. The current results found in the case of perceived social support systems tended to agree with those of other investigations of psychiatric and college populations. While the hypothesis concerning the relationship between length of illness and depression severity was not supported in the predicted direction the results were similar to those found by one team of investigators. Two reasons were proposed for the lack of the predicted relationship in regard to length of illness and depression severity. The early MS research that provided the basis for the present hypothesis often lacked adequate patient selection and/or objective, valid methodology. In addition, it was suggested that onset of MS may be viewed as a type of crisis situation involving several stages and that it might take a period of time before the stage of depression is reached. A comparison was made between an instrumental learning paradigm (involving a variable interval schedule of reinforcement) and the present results that indicate that patients who have experienced remissions are less depressed. The importance of social support for these patients was likewise explored and the conclusion drawn that this may be the only area where real help is possible for such patients. Several areas for possible future research were suggested including: premorbid (or pre-illness) personality factors, perception of patients by significant others, and body image and self-concept of patients with MS.
MCIVOR, GERALDINE PATRICIA, "DEPRESSION IN MULTIPLE SCLEROSIS AS A FUNCTION OF LENGTH AND SEVERITY OF ILLNESS, AGE, REMISSIONS, AND PERCEIVED SOCIAL SUPPORT" (1981). ETD Collection for Fordham University. AAI8111549.