An epidemiological description of physical, social and psychological problems in multiple sclerosis

Chronic disorders such as multiple sclerosis have important behavioural consequences on the lives of patients. The purpose of this study was to describe the frequency distribution of psychosocial disability among a referral clinic population of multiple sclerosis patients and to identify associated factors. A cross-sectional survey was conducted of 301 patients using four health indexes to assess quality of life. An 82% response rate was obtained. In the results are presented the frequencies of behavioural problems compared with the general population and a family practice group. While physical function was found to be closely associated with disease severity, psychosocial disability bore little relationship to the underlying disease or to sociodemographic variables including social class. Eighty percent of psychosocial disability remained unexplained. The physical aspects of multiple sclerosis were not predictive of emotional or social morbidity. The major implication of these findings is that the impact of disease on patients, as distinct from the disease itself, should be dealt with as health problems in their own right.