CP11
Behavioral Medicine in Multiple Sclerosis: Exploring Changes in Emotional and Physical Functioning
MS is a disease in which approximately 50% of the individuals will experience a depression and 40% an anxiety at some point during their disease, which is four times as high as in any other neurologic condition. (1-2). The completed suicide rate is 7.5 times as high as the GP (2). In addition, anxiety is reported more often than depression in neurology clinics and has been linked to the presence of exacerbations and psuedoexacerbations and if left untreated, can worsen MS symptoms by increasing functional impairment, decrease adherence to treatment, worsen quality of life and may lead to suicidal ideation and completion (3). Mind-body interventions such as exercise, relaxation, stress management and cognitive-behavioral therapy have been helpful in managing these symptoms and in the prevention of brain lesions (4). This has highlighted the benefits of psychotherapy post-treatment or at months following end of treatment; however, a report of MS patients’ change in emotional and physical functioning over time in patients who chose to receive health psychology services versus those who do not, is missing. In addition, no study has examined if the disease course has any significance in the outcome of behavioral medicine interventions.
Objectives: 1) identify how emotional and physical functioning changes over time in patients who choose to receive health psychology (HP) services at Mellen Center versus those who do not and, 2) determine if the MS disease course has any significant impact on the outcomes
Methods: Data was retrospectively collected on 8,235 patients with MS seen at Mellen Center for MS at the main campus of Cleveland Clinic between 01/01/2010 through 12/18/2014 using an IRB approved database. Patients 18 years old or older with a diagnosis of MS will be included in the sample. Data that will be used for this study will be exported from the Knowledge Program database for all patient visits, which includes inventories on mood, health status, and quality of life. Because patient follow-up is variable depending on symptoms severity, the data will be grouped by visit number. At each visit number, averages for the sample will be reported for all inventories.
Two primary analyses will be conducted to evaluate if patients who receive HP benefit from treatment. First, change scores will be calculated for patients who receive HP from emotional and physical functioning at intake vs. three sessions into treatment. Paired t-tests will be used to determine if this brief period of intervention results in patient improvement. Second, multilevel modeling will be used for the full sample of 8,235 patients examining changes in physical and emotional functioning since time of diagnosis based upon course of MS, demographic factors, and receipt of HP.
Results:
Data analyses not yet complete but will be by date of conference with the goal
Conclusions:
Data analyses not yet complete but will be by date of conference