title: Cross-Sectional Examination of the Associations Between Symptoms, Community Integration, and Mental Health in Multiple Sclerosis.
abstract: OBJECTIVE
  To determine the frequency and severity of 8 symptoms in persons with multiple sclerosis (MS) and to examine the association between these symptoms and community integration and mental health.
  
  
  METHODS
  Cross-sectional survey that assessed 8 symptoms (pain, fatigue, imbalance, numbness, weakness, shortness of breath, vision loss, and memory loss), disease progression (self-report version of the Expanded Disability Status Scale), community integration, and mental health.
  
  
  METHODS
  Community.
  
  
  METHODS
  Adults with self-reported MS who responded to a mailed survey (N=180).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  The presence and intensity of symptoms were measured with a symptoms checklist. Community integration was assessed with the Community Integration Questionnaire, and mental health was measured by the Mental Health Index of the Medical Outcomes Study 36-Item Short-Form Health Survey.
  
  
  RESULTS
  The average number of symptoms reported was 5.07±2.18. The most common symptoms (fatigue, weakness, and imbalance) were also rated as the most severe. Not all symptoms were associated with level of disease progression or with MS subtype. Symptoms related to mobility were more likely to be associated with these variables. The 8 symptoms as a whole accounted for significant amounts of variance (range, 13%-21%) in measures of community integration and mental health, with specific symptoms making differential independent contributions to these measures.
  
  
  CONCLUSIONS
  This study demonstrates that most individuals with MS report a number of bothersome symptoms. Type of MS or level of progression does not tell the whole story regarding the impact of symptoms.
authors.affiliation: Department of Physical Medicine and Rehabilitation Medicine, University of Michigan, Ann Arbor, MI. Electronic address: alkratz@med.umich.edu.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Kratz
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Ehde
authors.affiliation: Seattle Psychology, Seattle, WA.
authors.forename: Marisol A
authors.initials: MA
authors.lastname: Hanley
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Jensen
authors.affiliation: Evidence Based Treatment Centers of Seattle, Seattle, WA.
authors.forename: Travis L
authors.initials: TL
authors.lastname: Osborne
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors.forename: George H
authors.initials: GH
authors.lastname: Kraft
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D062309:Community Integration; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology* / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Community integration; Fatigue; Multiple sclerosis; Pain; Rehabilitation