A PEER-REVIEWED JOURNAL OF RESEARCH AND CLINICAL MEDICINEISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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The Effects of Depression in Multiple Sclerosis Patients on Their Attitude to the Disease

DOI:10.31550/1727-2378-2020-19-9-71-76
For citation: Zarubina N.V., Spirin N.N., Bykanova M.A. The Effects of Depression in Multiple Sclerosis Patients on Their Attitude to the Disease. Doctor.Ru. 2020; 19(9): 71–76. (in Russian). DOI: 10.31550/1727-2378-2020-19-9-71-76
26 november 2020

Study Objective: To study the types of attitude to their disease in multiple sclerosis (MS) patients and the effects of depressive disorders on the internal picture of the disease.

Study Design: This was a comparative prospective study.

Materials and Methods: One hundred and twenty-nine patients with clinically verified MS, aged 15 to 61, participated in the study. They were divided into two groups: those who had MS without depression (n = 56) and those who had both MS and depression (n = 73). The study tools included the А. Beck Depression Inventory; a depression self-assessment scale developed at the V.M. Bekhterev Research Institute; the Khanin modification of the Spielberger State-Trait Anxiety Inventory, intended to assess personality-related and reactive anxiety; the Asthenia Assessment Scale developed by L.D. Malkova; and the “Mini-Mult” and “Attitude to Disease” personality assessment tools.

Study Results: The study revealed that more than half of the MS patients had depression. The severity of their depressive disorders was consistent with a moderate depressive episode. Personality assessment of the MS patients with depression showed that women had high scores on the scales for depression and hysteria and moderate scores on the scales for paranoia and schizoid tendencies and males had high scores on the scales for psychopathy, paranoia, and psychasthenia. In the group of MS patients without depression, there were no statistically significant differences in scale scores between men and women.

The MS patients without depression more often demonstrated ergopathic (р = 0.0006), anosognosic (p = 0.00003), or balanced (p = 0.01) attitudes to the disease, with a focus on maintaining their occupational status and continuing an active life, while the MS patients with depression exhibited attitudes related to particular personality traits, with signs of a disturbed social maladjustment and advantage by illness. Men with both MS and depression more often had neurasthenic and hypochondriacal attitudes and women with both MS and depression more frequently have sensitive, egocentric, paranoid or dysphoric attitudes to the disease, which are characterized by even more markedly disturbed social adjustment and various types of maladaptive behavior (using others to achieve their goals), and aggressive tendencies.

Conclusion: Depressive disorders in MS patients significantly change their psychological structure and how they see the world around them, and reduce their resource capacities, making social adjustment more challenging and worsening their quality of life.

When affective disorders are diagnosed in a timely manner and treated in their early stages, patients with MS choose more adaptive mechanisms of psychological defense and more adaptive attitudes to the disease, which improves their quality of life.

Contributions: Dr. N.V. Zarubina diagnosed mental disorders, carried out psychological testing of the multiple sclerosis patients, and collected and processed scientific data. Dr. N.N. Spirin developed the design of the study and provided scientific guidance. Dr. M.A. Bykanova assessed patients’ neurological status and confirmed the diagnosis of multiple sclerosis.

Conflict of interest: The authors declare that they do not have any conflict of interests.

N.V. Zarubina (Corresponding author) — Yaroslavl State Medical University (a Federal Government-funded Educational Institution of Higher Education), Russian Federation Ministry of Health; 5 Revolutsionnaya St., Yaroslavl, Russian Federation 150000. eLIBRARY.RU SPIN: 1828-1858. E-mail: ntshzarubina@rambler.ru

N.N. Spirin — Yaroslavl State Medical University (a Federal Government-funded Educational Institution of Higher Education), Russian Federation Ministry of Health; 5 Revolutsionnaya St., Yaroslavl, Russian Federation 150000. E-mail: nnspirin@yandex.ru

M.A. Bykanova — Yaroslavl State Medical University (a Federal Government-funded Educational Institution of Higher Education), Russian Federation Ministry of Health; 5 Revolutsionnaya St., Yaroslavl, Russian Federation 150000. eLIBRARY.RU SPIN: 1777-3289. E-mail: privase@mail.ru

Доктор.ру

Fig. 1. Frequency of depression in multiple sclerosis (MS) patients

r11_1.jpg 

Table 1
Comparison of emotional disorders in multiple sclerosis (MS) patients, scores (M ± σ)

t11_1.jpg

Fig. 2. Prevalence of various types of attitude to the disease in multiple sclerosis (MS) patients, %

r11_2.jpg

Table 2
Types of attitude to the disease in multiple sclerosis (MS) patients, scores (M ± σ)

t11_2.jpg

Received: 14.08.2020
Accepted: 09.09.2020

26 November 18:20
REFERENCES
  1. Vasilyeva N.V., Nikolaev E.L. Individual and personal characteristics of patients with multiple sclerosis. Neurology Bulletin. 2015; XLVII(1): 67–72. (in Russian). DOI: 10.17816/nb13917
  2. Isaeva E.R. Mechanisms of psychological adaptation of the personality: Modern approaches to the study of coping and psychological defense. Bulletin of St. Petersburg State Medical University. Series 12. Psychology. Sociology. Pedagogy. 2008; 2: 40–6. (in Russian)
  3. Isaeva E.R. The coping/defense style of personality adjustment: an analysis of relationships between coping and psychological defense. Russian Scientific Journal. 2009; 10: 40–6. (in Russian)
  4. Lazareva E.Yu., Nikolaev E.L. A system for multi-level personality adaptation during disease. Chuvash Bulletin of Psychiatry and Psychology. 2012; 8: 93–104. (in Russian)
  5. Matveeva T.V., Mendelevich V.D., Rechanik D.P. Types of mental disorders in multiple sclerosis patients. Neurological Bulletin. 2002; XXXIV(1–2): 69–73. (in Russian)
  6. Petrova E.A., Shmeleva S.V., Golenkov A.V. Psychology. M.: 2013. 352 p. (in Russian)
  7. Trifonova E.A. Coping strategies and physical health: theoretical approaches and empirical studies. Izvestia: Herzen University Journal of Humanities and Sciences. 2012; 145: 96–108. (in Russian)
  8. Barabash I.A., Karnaukh V.N. Attitude to the disease in multiple sclerosis. Abstracts of papers submitted at the IX All-Russia Neurology Conference, Yaroslavl, May 29 — June 2, 2006. Yaroslavl; 2006: 303. (in Russian)
  9. Reznikova T.N., Seliverstova N.A., Fedoryaka D.A. The significance of conscious and unconscious emotional processes in multiple sclerosis. Bulletin of the I.I. Mechnikov North-Western State Medical University. 2017; 9(3): 53–8. (in Russian)
  10. Dobson K.S. The relationship between anxiety and depression. Clin. Psychol. Rev. 1985; 5(4): 307–24. DOI: 10.1016/0272-7358(85)90010-8
  11. Dibrivnaia K.A., Enikolopova E.V., Zubkova Yu.V. et al. Characteristics of coping strategies in patients with multiple sclerosis (review). S.S. Korsakov Journal of Neurology and Psychiatry. 2013; 113 (2): 48–52. (in Russian)
  12. Reznikova T.N., Seliverstova N.A., Semivolos V.I. Important issues of psychological rehabilitation of multiple sclerosis patients. The XVII All-Russia Conference “Neuroimmunology. Multiple Sclerosis” and Research-to-Practice Neurology Conference, St. Petersburg, April 27–30, 2009. SPb.: 2009: 87–8. (in Russian)
  13. Nikolaev E.L. Borderline illnesses as a psychological and cultural phenomenon. Cheboksary; 2006. 384 p. (in Russian)
  14. Sobolev V.A., Chumakov D.V., Davydova I.A. et al. The research peculiarities preferences in selecting coping strategies illness behavior in patients with depressive disorders. Proceedings of the II Russian-Croatian International Congress on Spiritual Psychiatry. M.; 2014: 140–1. (in Russian)
  15. Archer J., Bower P., Gilbody S. et al. Collaborative care for depression and anxiety problems. Cochrane Database Syst. Rev. 2012: CD006525. DOI: 10.1002/14651858.CD006525.pub2
  16. Feinstein A., Feinstein K. Depression associated with multiple sclerosis. Looking beyond diagnosis to symptom expression. J. Affect. Disord. 2001; 66(2–3): 193–8. DOI: 10.1016/s0165-0327(00)00298-6

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