• Susana Sainz de la Maza, Jorge Maurino, Tamara Castillo-Triviño, Mónica Borges, Berta Sebastián Torres, Javier Sotoca, Ana María Alonso Torres, Ana B Caminero, Laura Borrega, José L Sánchez-Menoyo, Francisco J Barrero-Hernández, Carmen Calles, Luis Brieva, María Rosario Blasco, Julio Dotor García-Soto, Ana Rodríguez-Regal, Laura Navarro-Cantó, Eduardo Agüera-Morales, Moisés Garcés, Olga Carmona, Laura Gabaldón-Torres, Lucía Forero, Mariona Hervás, and Rocío Gómez-Ballesteros.
• Department of Neurology, Hospital Universitario Ramón y Cajal, Madrid, Spain.
• Patient Prefer Adher. 2023 Jan 1; 17: 143114391431-1439.

BackgroundHopelessness is a risk factor for depression and suicide. There is little information on this phenomenon among patients with relapsing-remitting multiple sclerosis (RRMS), one of the most common causes of disability and loss of autonomy in young adults. The aim of this study was to assess state hopelessness and its associated factors in early-stage RRMS.MethodsA multicenter, non-interventional study was conducted. Adult patients with a diagnosis of RRMS, a disease duration ≤ 3 years, and an Expanded Disability Status Scale (EDSS) score of 0-5.5 were included. The State-Trait Hopelessness Scale (STHS) was used to measure patients´ hopelessness. A battery of patient-reported and clinician-rated measurements was used to assess clinical status. A multivariate logistic regression analysis was conducted to determine the association between patients' characteristics and state hopelessness.ResultsA total of 189 patients were included. Mean age (standard deviation-SD) was 36.1 (9.4) years and 71.4% were female. Median disease duration (interquartile range-IQR) was 1.4 (0.7, 2.1) years. Symptom severity and disability were low with a median EDSS (IQR) score of 1.0 (0, 2.0). A proportion of 65.6% (n=124) of patients reported moderate-to-severe hopelessness. Hopelessness was associated with older age (p=0.035), depressive symptoms (p=<0.001), a threatening illness perception (p=0.001), and psychological and cognitive barriers to workplace performance (p=0.029) in the multivariate analysis after adjustment for confounders.ConclusionHopelessness was a common phenomenon in early-stage RRMS, even in a population with low physical disability. Identifying factors associated with hopelessness may be critical for implementing preventive strategies helping patients to adapt to the new situation and cope with the disease in the long term.© 2023 Sainz de la Maza et al.

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