Curatoli Chiara, Marcassoli Alessia, Barbadoro Filippo, Fornari Arianna, Leonardi Matilde, Raggi Alberto, Schiavolin Silvia, Terragni Rachele, Antozzi Carlo, Brambilla Laura, Torri Clerici Valentina, Confalonieri Paolo, Mantegazza Renato, Lanza Martina
Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Behav Neurol. 2025 Jan 10;2025:2744955. doi: 10.1155/bn/2744955. eCollection 2025.
Multiple sclerosis (MS) is the most common cause of disability in young adults due to several motor, sensory, and cognitive symptoms. However, little is still known about the impact of psychological, cognitive, and social-support variables on subjective disability. This study is aimed at exploring the role of clinical, psychological, cognitive, and social-support variables in predicting disability levels as perceived by persons with multiple sclerosis (pwMS). The World Health Organization Disability Assessment Schedule (WHODAS 2.0) and the Expanded Disability Status Scale (EDSS) were used as subjective and objective measures of disability, respectively. State-Trait Anxiety Inventory and Beck Depression Inventory-II assessed symptoms of anxiety and depression; 19-item Medical Outcome Study-Social Support Survey assessed social support; and Rao's Brief Repeatable Battery assessed cognitive functioning. A multivariable regression analysis was applied using the WHODAS 2.0 as an outcome. One hundred and fifty-one pwMS (93 females, mean age 51.6, standard deviation (SD) 5.8) were enrolled. EDSS ( = 7.190; < 0.001), state anxiety ( = 0.265; = 0.009), and symptoms of depression ( = 0.835; < 0.001) explained a large amount of the variance of subjective disability (Adj. = 0.705; < 0.001) measured through the WHODAS 2.0. Contrarily, cognitive functioning and perceived social support are not independently associated with the WHODAS 2.0 score. Psychosocial interventions in rehabilitation settings, aimed at reducing the overall perceived disability of pwMS, should be implemented in rehabilitation programs.
多发性硬化症（MS）是导致年轻人残疾的最常见原因，会引发多种运动、感觉和认知症状。然而，心理、认知和社会支持变量对主观残疾的影响仍知之甚少。本研究旨在探讨临床、心理、认知和社会支持变量在预测多发性硬化症患者（pwMS）所感知的残疾水平方面的作用。世界卫生组织残疾评估量表（WHODAS 2.0）和扩展残疾状态量表（EDSS）分别用作残疾的主观和客观测量指标。状态-特质焦虑量表和贝克抑郁量表-II评估焦虑和抑郁症状；19项医学结局研究-社会支持调查评估社会支持；Rao简短可重复成套测验评估认知功能。以WHODAS 2.0作为结果进行多变量回归分析。共纳入151例pwMS患者（93例女性，平均年龄51.6岁，标准差（SD）5.8）。EDSS（β = 7.190；P < 为0.001）、状态焦虑（β = 0.265；P = 0.009）和抑郁症状（β = 0.835；P < 0.001）解释了通过WHODAS 2.0测量的主观残疾的大量方差（调整后R² = 0.705；P < 0.001）。相反，认知功能和感知到的社会支持与WHODAS 2.0评分没有独立关联。康复环境中的心理社会干预旨在降低pwMS患者的总体主观残疾感，应在康复计划中实施。
