Threatening Illness Perception and Associated Factors in Early-stage Relapsing Remitting Multiple Sclerosis

Objective: The aim of this study was to assess the illness perception and associated factors in early-stage relapsing remitting multiple sclerosis (RRMS) patients. Background: Patients with early-stage RRMS experience uncertainty and intense emotions as diagnosis is disclosed. Illness perception at this point can influence levels of adjustment, coping strategies, and patients’ well-being. Design/Methods: A multicentre, non-interventional study was conducted. Adult patients with RRMS, disease duration ≤3 years, and Expanded Disability Status Scale (EDSS) score between 0–5.5 were included. The Brief-Illness Perception Questionnaire (B-IPQ) was used to assess patients’ cognitive and emotional illness representation. Patient-reported measures were administered to gather information on different outcomes. A multivariate logistic regression analysis was performed to assess the association between B-IPQ and demographic, clinical characteristics, and patients’ perspectives. Results: A total of 189 patients were included (mean age: 36.1±9.4 years, 71.4% female, mean disease duration: 1.4±0.8 years). Median EDSS score was 1.0 (IQR=0.0–2.0). A proportion of 36.5% (n=69/189) patients had a moderate-to-high threatening illness perception, and 45.5% of patients thought that their MS was caused by psychological factors. Bivariate analyses suggested that patients were significantly more likely to have a threatening disease perception if they were unemployed, received symptomatic treatment, had a higher EDSS, worse hand dexterity and gait, higher perception of pain, fatigue, symptom severity, hopelessness, and worse perception of their quality of life. Also patients that reported workplace barriers, cognitive complaints, and probable cases of anxiety, depression, and stigma. Higher EDSS, symptom severity, worse psychological quality of life, perception of stigma, and higher hopelessness-trait were predictors of moderate-to-high threatening illness perception (OR=2.349, 95%CI:1.276–5.130; OR=1.208, 95%CI:1.089–1.364; OR=1.051, 95%CI:1.018–1.089; OR=3.365, 95%CI:1.152–10.796; OR=41.177, 95%CI:6.942–388.825, respectively, all p<0.05). Conclusions: Threatening illness perceptions are common among patients with early RRMS. Identifying these beliefs and its associated factors and establishing individualized interventions may help patients deal with their condition. Disclosure: Susana Sainz de la Maza has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Almirall, Biogen, Merck, Novartis, Roche and Sanofi-Genzyme. Ms. Gómez has received personal compensation for serving as an employee of Roche Farma Spain, Medical Department. Mrs. Borges Guerra has nothing to disclose. Jesus Manuel Martin Martinez has nothing to disclose. Mr. Sotoca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. Mr. Sotoca has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Mr. Sotoca has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Mr. Sotoca has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Mr. Sotoca has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Mr. Sotoca has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Alonso Torres has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Dr. Alonso Torres has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Alonso Torres has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Caminero Rodriguez has nothing to disclose. Dr. Borrega Canelo has nothing to disclose. Dr. Sanchez Menoyo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Sanchez Menoyo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Dr. Sanchez Menoyo has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Sanchez Menoyo has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Sanchez Menoyo has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Barrero-Hernandez has nothing to disclose. Dr. Calles has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi, Biogen, Roche, Teva, Novartis, Merck. Dr. Calles has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi, Teva, Biogen, Roche, Novartis, Merck. Dr. Brieva Ruiz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for All comercial companies interested in Multiple Sclerosis. Dr. Brieva Ruiz has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Al comercial companies in Multiple Sclerosis. The institution of Dr. Brieva Ruiz has received research support from Carlos III Institut. Madrid. Spain.. Rosario Blasco Quilez has nothing to disclose. JULIO DOTOR GARCÍA-SOTO has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck . JULIO DOTOR GARCÍA-SOTO has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Merck, Biogen, Sanofi-Genzyme, Almirall, Teva, UCB, Novartis. Maria Campo Amigo has nothing to disclose. Laura Navarro has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Laura Navarro has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen idec. Laura Navarro has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi-Genzyme. Dr. Aguera Morales has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Aguera Morales has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis . Dr. Aguera Morales has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Aguera Morales has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Aguera Morales has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Mr. Garces Redondo has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Mr. Garces Redondo has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Mr. Garces Redondo has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Almirall. Mr. Garces Redondo has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Novartis. Dr. Carmona has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for MERCK. Dr. Carmona has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for BIOGEN . Mrs. Laura has nothing to disclose. Lucía Forero has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Lucía Forero has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Roche . Mariona Hervas Pujol has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi, Merk, Bayer, Biogen, Almirall. Jorge Maurino has received personal compensation for serving as an employee of Roche Pharma Spain, Medical Department. Dr. Castillo-Trivino has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Castillo-Trivino has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Castillo-Trivino has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Castillo-Trivino has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Castillo-Trivino has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Castillo-Trivino has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol-Myers Squibb. The institution of Dr. Castillo-Trivino has received research support from Basque Government.