The Value of Clinical Screenings for Concurrent Problems in Patients with Multiple Sclerosis Who Identify As Having Cognitive Problems

Background: Research indicates that as many as 65% of patients with Multiple Sclerosis will exhibit cognitive impairment.  Pain, depression, and anxiety are known factors that adversely impact cognitive functioning, but these influences are often unrecognized by patients.   If patients communicated coexistence of these issues at the time they reported cognitive concerns, opportunities for education on the role of psychosocial factors in cognitive dysfunction could increase the likelihood that patients would consider rather than discount the benefits of psychosocial treatment interventions for enhancing cognitive functioning.  

Objectives: This study aims to investigate whether patients identifying problems with pain, depression, or anxiety during screening, when given the opportunity to identify multiple problems, were also more likely to endorse concerns with cognitive functioning.

Methods: In support of medical care, 259 patients at a Southeastern US MS Center were screened (79.5% female, 55% Caucasian, mean age = 46.67) for various psychosocial problems under the purview of Health Psychology.

Results: Using logistic regression, patients who endorsed being bothered by pain were nearly 4 times as likely to report coexistence of subjective concern of cognitive functioning (p = .022) as those who did not.  Patients who identified depression as a current problem were more than 3 times as likely to also report cognitive concerns (p = .005) than those without reported concern of depression.  There was a non-significant trend for patients who identified experiencing anxiety to be more than twice as likely to report cognitive concerns as well (p= .074) compared to those who did not report anxiety.

Conclusions: These results support that patients’ subjective complaints of pain, depression, and anxiety often co-occur with concerns about cognitive functioning at the time of screening.  Results highlight the importance of clinicians providing patients with opportunity to identify multiple concerns before selecting the focus of intervention.  By facilitating, through screening, patients’ self-report of pain, depression, and anxiety as areas of concern when reporting cognitive concerns, the provider’s ability to educate patients on treatment interventions that impact pain, depression, and anxiety (and often, as a consequence, cognitive functioning) may be strengthened.