The Impact of Stigma on Perceived Quality of Life and Experience of Anxiety and Depression in Individuals Diagnosed with MS

Background: While the experience of stigma in the lives of those diagnosed with chronic illnesses has been acknowledged, there is an ever-growing need for academic literature specifically focused on those persons with multiple sclerosis (PwMS) (Earnshaw & Quinn, 2012). The current literature demonstrates how exposure to stigma can lead to decreased self-esteem, lower perceived availability of social support, and mood symptoms in PwMS (Cook, Germano, & Stadler, 2016). However, it is unclear the degree to which mood symptoms (e.g., anxiety, depression) and stigma experienced by PwMS impacts perceived quality of life (Gruber-Baldini, Velozo, Romero & Shulman, 2017).

Objectives: The current study will examine stigma and its impact on quality of life through the experience of mental health symptoms (i.e., depression and anxiety) in PwMS. Identifying the impact of stigma and mood symptoms on perceived quality of life in PwMS will provide important information to tailor our approach when assisting patients to overcome challenges associated with MS and increase positive health outcomes, such as adherence to treatment regimens and engagement with sources of support. Specifically, the current project objective is to develop a manuscript to support these aims.

Methods: Retrospective data from the Quality of Life in Neurological Disorders (Neuro-QoL) set of measures, collected within the Multiple Sclerosis Performance Test (MSPT), will be utilized. The MSPT comprises a battery of neuroperformance tests and quantitative patient-reported outcome measures administered using a tablet-based application developed at the Cleveland Clinic. Patient and clinical characteristics will be summarized using descriptive statistics for the entire patient sample and stratified by baseline (first visit with Neuro-QoL stigma T-score) levels of stigma (low = Neuro-QoL Stigma T-score < 40, medium = 40 ≤ Neuro-QoL Stigma T-score ≤ 60, and high = Neuro-QoL Stigma T-score > 60). Comparisons will be made using one-way analysis of variance (ANOVA) or Kruskal-Wallis test for continuous variables and chi-square or Fisher’s exact test for categorical variables. Pearson correlations will be calculated to assess the association between Neuro-QoL Stigma T-scores and T-scores from other Neuro-QoL scales. Correlations between baseline scores and also change in score (6-month score – baseline score) will be computed. The independent association between (baseline and change in score) Neuro-QoL Stigma T-scores and T-scores from other Neuro-QoL scales will be assessed through multivariable linear regression models to adjust for confounding variables. Frequency and percent of missing values will be examined for each variable and, if necessary, missingness will be handled using multivariate imputation by chained equations.

Results: Results will be available at time of conference.

Conclusions: Conclusions will be available at time of conference.