title: Predictors of quality of life among multiple sclerosis patients: a comprehensive analysis.
abstract: OBJECTIVE
  Multiple sclerosis (MS) is a debilitating neurological disease of young people with substantial consequences on patients' quality of life (QOL). A variety of QOL instruments have been used to evaluate the efficacy of treatments. However, no study assessed the role of the different demographic, clinical, physical, social, economic and psychological parameters in the perception of patients with MS of their QOL.
  
  
  METHODS
  Two-hundred and one consecutive patients attending outpatient clinics were prospectively studied and objectively assessed using Expanded Disability Status Scale (EDSS), 8-m walk test, and Symbol Digit Modality Test. Patients completed the following questionnaires: MS QOL-54, Hamilton Depression Rating Scale, Fatigue Severity Scale, Brief Pain Inventory Average Pain Score, Drug Side-Effects Severity Scale, Social Support, Religiosity, Physiotherapy and Exercise, and Socioeconomic Profile. Overall, QOL, physical (PHCS) and mental (MHCS) health composite scores were computed as outcome measures from MSQOL-54.
  
  
  RESULTS
  Depression, social support, religiosity, education years and living area predicted overall QOL by linear regression (R(2) = 0.43). Unemployment and absence of fatigue correlated with poor and good QOL, respectively. Fatigue, pain, depression, EDSS, social support, MS type and anti-cholinergic treatment predicted PHCS (R(2) = 0.81). Fatigue, pain, depression, education years and social support predicted MHCS (R(2) = 0.70).
  
  
  CONCLUSIONS
  The QOL in patients with MS is not solely determined by physical disability, but rather by the level of social support, living area, depression, level of education, employment, fatigue and religiosity. Accordingly, we suggest that these should be evaluated in every patient with MS as they may be modified by targeted interventions.
authors.affiliation: Department of Neurology, American University of Beirut, Beirut, Lebanon. yamoutba@idm.net.lb
authors.forename: B
authors.initials: B
authors.lastname: Yamout
authors.forename: Z
authors.initials: Z
authors.lastname: Issa
authors.forename: A
authors.initials: A
authors.lastname: Herlopian
authors.forename: M
authors.initials: M
authors.lastname: El Bejjani
authors.forename: A
authors.initials: A
authors.lastname: Khalifa
authors.forename: A S
authors.initials: AS
authors.lastname: Ghadieh
authors.forename: R H
authors.initials: RH
authors.lastname: Habib
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D015444:Exercise; D005221:Fatigue / Q000150:complications / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D010146:Pain / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D012067:Religion; D012944:Social Support