The Effect Of Fatigue, Cognitive And Affective Disorders On Quality Of Life Of Patients With Multiple Sclerosis

Objective To investigate the situation and characteristic of fatigue, cognitive impairment, depression, anxiety of the first multiple sclerosis (MS), and to learn the effects of fatigue, cognitive impairment, depression, anxiety on patients'quality of life. Thus clinicians give MS patients targeted interventions and treatment, It's significant to relieve patient's suffering, lighten the families cares pressure in the whole societyMethods45cases diagnosed MS patients came from impatient of the first affiliated hospital of Kunming Medical University from march2010to february2012, while there are30control cases whose age, gender, education level and marital status matched with MS group. We use the Modified fatigue impact scale (MFIS), the Mini-mental state examination (MMSE), the Rey auditory verbal learning test (AVLT), the Rey complex figure test (CFT), the Symbol digit modalities test (SDMT), the Stroop color-word test (CWT), the Executive clock drawing test (CLOX), the Verbal fluency test (VFT), the Hamilton depression scale (HAMD), the Hamilton anxiety scale (HAMA), the Expanded disability status scale (EDSS), the Multiple sclerosis quality of life-54(MSQOL-54), as to evaluate the cognitive function, short and long term memory, visual perceptual function, information processing speed, executive function, depression, anxiety and quality of life of two groups. Then to collate the gathered information to quantify the analytical variables and carry out the appropriate statistical analysis.Results (1)MSQOL-54test found, when compared with the healthy control group, all aspects of quality of life of MS patients score lower, There were significant differences between MS patients and the healthy control group in the scores of quality of life of MS, except the pain score (P<0.05).(2)The MFIS test found,25of45MS patients was fatigue, the incidence of fatigue was55.6%. Fatigue have a significant impact on the quality of life of MS patients in role limitations due to physical problems, role limitations due to emotional problems, emotional status, energy, health awareness, cognitive function, health stress, and overall quality of life (P<0.01).(3)AVMT test found, when compared with the healthy control group, the MS patients short-delay memory test and long-delay memory test results decreased (P<0.05), but recognition was no significant difference between the two groups (P>0.05).(4)Stroop test found, there was no significant difference on the number of response errors (P>0.05), but there was significant difference on reaction time, the MS group reaction time was slower than the healthy controls group (P<0.05).(5)SDMT test found, when compared with the healthy control group, the SDMT test scores of MS patients was decreased (P<0.05).(6)There was no correlation between short-delay memory, long-delay memory, Stroop2, SDMT test scores and various aspects of quality of life (P>0.05).(7)H AMD test found,13of45MS patients was depression, the incidence of depression was28.9%, depression was a possible state of depression; HAMA test found,10of45MS patients was anxiety, the incidence of anxiety was22.2%. Anxiety was a possible state of anxiety, depression accompanied by anxiety was8cases, the incidence rate of17.8%.(8)There was no significant differences between group of MS patients with depression accompanied by anxiety, with depression, with anxiety, and patients with no affective disorder on quality of life impact (P>0.05)Conclusions:(l)The first diagnosis of MS patients quality of life reduced, especially the effect of fatigue on quality of life significantly.(2)The mainly impaired areas of cognitive function in MS were memory, executive functions, information processing speed. In contrast, general cognitive function and language skills generally remain preserved. Cognitive impairment had no significant effect on the quality of life of patients with first diagnosis of MS.(3)There was a higher incidence of depression and anxiety in MS patients, usually the possible state of depression and anxiety. Depression and anxiety had no significant effect on the quality of life of patients with first diagnosis of MS.