Objective

At the time of multiple sclerosis (MS) diagnosis, identifying those at risk for poorer health-related quality of life and emotional well-being can be a critical consideration for treatment planning. This study aimed to test whether adverse childhood experiences predict MS patients’ health-related quality of life and emotional functioning at time of diagnosis and initial course of disease.

Methods

We recruited patients at the time of new MS diagnosis to complete self-report surveys at baseline and a one-year follow-up. Questionnaires included the Adverse Childhood Experiences (ACEs), as well as the MS Knowledge Questionnaire (MSKQ), the 36-Item Short Form Health Survey (SF-36), and Self-Management Screening (SeMaS).

Results

A total of n = 31 participants recently diagnosed with relapsing remitting MS (median EDSS = 1.0, age M = 33.84 ± 8.4 years) completed the study measures. The ACEs significantly predicted health-related quality of life (SF-36) at baseline (Adjusted R² = 0.18, p = 0.011) and follow-up (Adjusted R² = 0.12, p = 0.03), baseline scores on the SeMaS Depression scale (Adjusted R² = 0.19, p = 0.008), as well as follow-up scores on the SeMaS Anxiety (Adjusted R² = 0.19, p = 0.014) and SeMaS Depression (Adjusted R² = 0.14, p = 0.036) scales. Importantly, increased ACEs scores were predictive of increased anxiety at the one-year follow-up assessment, compared to baseline.

Conclusions

Childhood adversity predicts health-related quality of life and emotional well-being at time of MS diagnosis and over the initial course of the disease. Measured using a brief screening inventory (ACEs), routine administration may be useful for identifying patients in need of increased supportive services.

中文翻译：

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不良童年经历可预测对多发性硬化症诊断的反应

客观的

在多发性硬化症 (MS) 诊断时，识别那些面临与健康相关的生活质量和情绪健康状况较差的风险可能是治疗计划的关键考虑因素。本研究旨在测试不良童年经历是否可以预测 MS 患者在诊断时和疾病初始过程中与健康相关的生活质量和情绪功能。

方法

我们在新诊断 MS 时招募了患者，以在基线和一年的随访中完成自我报告调查。问卷包括不良童年经历 (ACE)、MS 知识问卷 (MSKQ)、36 项简短健康调查 (SF-36) 和自我管理筛查 (SeMaS)。

结果

共有n = 31 名最近被诊断为复发缓解型 MS 的参与者（中位 EDSS = 1.0，年龄 M = 33.84 ± 8.4 岁）完成了研究措施。ACE 显着预测基线（调整后的R ² = 0.18，p = 0.011）和随访（调整后的R ² = 0.12，p = 0.03）、SeMaS 抑郁症的基线评分时的健康相关生活质量 (SF-36)量表（调整后的R ² = 0.19，p = 0.008），以及 SeMaS 焦虑（调整后的R ² = 0.19，p = 0.014）和 SeMaS 抑郁（调整后的R ² = 0.14，p = 0.036) 尺度。重要的是，与基线相比，ACEs 分数的增加预示着一年随访评估中焦虑的增加。

结论

童年逆境可预测 MS 诊断时和疾病初始过程中与健康相关的生活质量和情绪健康。使用简要筛查清单 (ACE) 进行测量，常规给药可能有助于识别需要增加支持服务的患者。