Diagnostic Criteria for Psychosomatic Research and Psychosocial Functioning in Multiple Sclerosis

BACKGROUND: Multiple sclerosis (MS) is a chronic neurodegenerative disorder, characterized by an unpredictable course and heterogeneous symptoms. Individuals with MS suffer from higher rates of anxiety and depression than the general population and have poorer quality of life scores when compared to range of chronic conditions. OBJECTIVE: This study aimed at investigating for the first time the prevalence of Diagnostic Criteria for Psychosomatic Research (DCPR) in patients with MS and the ability of the DCPR syndromes in predicting psychosocial functioning in addition to psychopathological symptoms and neurological disability. METHODS: 150 consecutive outpatients with MS, referred to Multiple Sclerosis Unit, Vito Fazzi Hospital, were recruited between October 2013 and December 2014. The Structured Interview for DCPR, Symptom Check List-90-R (SCL-90-R), Multiple Sclerosis Quality of life-54 (MSQoL-54), and the Expanded Disability Status Scale (EDSS) were used to perform psychometric and clinical assessment. RESULTS: A total of 107 patients (71.3%) met criteria for at least one DCPR and 60 patients (40%) had more than one DCPR. The more prevalent DCPR syndromes were Alexithymia (32.7%), Type A behavior (29.3%), and Demoralization (22.7%). Psychosomatic syndromes were associated with poor psychosocial functioning. GSI and Demoralization independently predicted the physical and mental component of psychosocial dysfunction over and above the level of neurological disabilities. CONCLUSIONS: DCPR classification can provide clinicians with a set of sensitive diagnostic criteria for a comprehensive assessment of MS patients. Among the DCPR, Demoralization more strongly affected the patients’ quality of life and might play a significant mediating role in the course of MS.