Assessment of emotional problems in people with multiple sclerosis.
OBJECTIVE
To investigate the occurrence of emotional problems in multiple sclerosis (MS) patients. The utility of rating scales used to measure such problems was studied to make recommendations for clinical practice.


METHODS
Questionnaires were both sent by post and completed with an assistant psychologist at a home visit.


METHODS
Ninety-six MS patients in contact with a rehabilitation consultant.


METHODS
Patients were assessed using the Guy's Neurological Disability Scale (GNDS), Extended Activities of Daily Living Scale (EADL), Hospital Anxiety and Depression Scale (HAD), Beck Anxiety and Depression Scales (BAI, BDI), Clinical Outcomes in Routine Evaluation Measure (CORE) and the Brief Symptom Inventory (BSI).


RESULTS
Rates of anxiety and depression ranged from 16% to 48% according to the measures used. All mood scales were highly significantly correlated with each other. Disability as measured by the GNDS, but not the EADL, was significantly correlated with all mood measures. Kappa values showed poor correspondence in the classification of cases. Receiver operating characteristic curves indicated an optimum cut-off point of 7/8 on the HAD and 2/3 on the General Health Questionnaire (GHQ-12).


CONCLUSIONS
Rates of emotional problems were low given the highly disabled population studied. The HAD was relatively insensitive in comparison with the BAI and BDI. The GHQ-12 was sensitive and therefore recommended as a short screening measure. An alternative short screen, 'Emotional GNDS', was proposed.
Nicholl
C R
CR
Department of Clinical Psychology, Central Notts Healthcare NHS Trust Headquarters and School of Psychology, University of Nottingham, UK.
Lincoln
N B
NB
Francis
V M
VM
Stephan
T F
TF
D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000523:psychology* / Q000534:rehabilitation; D011581:Psychological Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric