Quality of life in patients with multiple sclerosis: a pilot study

Uno studio pilota sulla qualità della vita in pazienti con sclerosi multipla

I. De Pascale

Psicologa-psicoterapeuta, Studio di Ricerca e Psicoterapia, Sava (TA)


The evaluation of health in relation to quality of life (Health Related Quality of Life-HRQOL) is a measure of the general quality of the life of a subject. It encompasses several areas: the state of health, both physical and psychological, social functioning, and it can also measure impairments, symptoms and disabilities. It is a measure of the individual perception of the functional role, social health and general comfort, as well as the sexual functioning and personal satisfaction of the individual. The symptom “sense of fatigue” has been taken into consideration because of its particular onset, in the manifestation (to completely disable a subject) and in incidence to determine its impact on quality of life. The measure of the quality of life helps to provide a broad quantification of the impact on the illness and to develop a programme of care that can satisfy the patient’s needs.


The study cohort consisted of 32 patients with a confirmed diagnosis of multiple sclerosis. The criteria for inclusion were: attending a rehabilitative centre for periodic psychiatric visits or physiotherapy; an EDSS < 7 (this is useful indicator of the global measure of the level of disability in a patient); informed consent for participation. All subjects were administered two tests: the Multiple Sclerosis Quality of Life Test (MSQOL-54) and the Modified Fatigue Impact Test Scales (MFIS), based on items derived from interviews with patients with multiple sclerosis that describe how fatigue influences their life.


The study population was heterogeneous. The results showed that a decrease in QoL corresponds to alteration of the “sense of fatigue”. This causes damage to physical and mental functioning of health. The high EDSS score is related to alteration of physical functioning, increased emotional well-being and cognitive function. Considering the age of subjects with multiple sclerosis, it would appear that increased age decreases physical and sexual functions, but without any other differences in the other functions measured. The duration of illness has more influence on the quality of life than age. Moreover, the years after the onset of the illness are related with some aspects of the QoL, particularly with cognitive function which seems to increase together with the number of years from diagnosis, whereas they are related to a decrease in physical functioning.


Change in behaviour in individuals with multiple sclerosis was observed both by patients and family, and these changes influence QoL in reference to mental health and physical and social functioning. Measures of QoL may be useful to assess the results of specific medical treatments. This is important since individualization of the risk of worsening of the state of health due to deterioration in physical and mental functions has psychological alterations such as the loss of identity, disesteem, sense of impotence, lack of independence, loss of personal control and fear of the future, which often leads to major depression.

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