title: Factors that impact health-related quality of life in neuromyelitis optica spectrum disorder: anxiety, disability, fatigue and depression.
abstract: OBJECTIVE
  Neuromyelitis optica spectrum disorder (NMOSD) is associated with reduced health-related quality of life (HRQOL). This study aimed to investigate factors that impact HRQOL in NMOSD.
  
  
  METHODS
  A series of questionnaires were completed by 73 patients to assess the relationships between HRQOL and fatigue, depression, anxiety and sleep disorder. We also evaluated the contributions of clinical characteristics to HRQOL. Correlation and regression analysis were conducted to identify factors that negatively impact HRQOL in NMOSD.
  
  
  RESULTS
  Pearson's correlation analysis showed that reduced HRQOL was strongly correlated with anxiety (r=-0.77, P=0.000), fatigue (r=-0.75, P=0.000) and depression (r=-0.73, P=0.000); and moderately correlated with disability (r=-0.53, P=0.000) and sleep disorder (r=-0.59, P=0.000). Stepwise regression analysis further revealed that anxiety was the best predictor of both the global and physical composite scores of HRQOL, followed by disability, fatigue and depression (global composite, r(2)=0.76, P=0.000; physical composite, r(2)=0.71, P=0.000). Depression, fatigue and anxiety were the main predictors of the mental health composite score of HRQOL (r(2)=0.69, P=0.000). Other factors did not have an effect on HRQOL.
  
  
  CONCLUSIONS
  This study revealed factors that impact HRQOL in NMOSD and provided the first demonstration that anxiety, disability, fatigue and depression are independent predictors of poor HRQOL in NMOSD.
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Ziyan
authors.initials: Z
authors.lastname: Shi
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Hongxi
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Zhiyun
authors.initials: Z
authors.lastname: Lian
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Ju
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Huiru
authors.initials: H
authors.lastname: Feng
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China. Electronic address: 924339836@qq.com.
authors.forename: Hongyu
authors.initials: H
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology*; D003863:Depression / Q000209:etiology*; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000150:complications* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012893:Sleep Wake Disorders / Q000209:etiology; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Anxiety; Depression; Fatigue; Neuromyelitis optica; Quality of life