Impacto del estrés y de las variables psicosociales en el curso clínico y en la calidad de vida de los afectados por la esclerosis múltiple = The impact of stress and the psychosocial variables on both the course of the disease and quality of life of multiple sclerosis patients

The effects of stress on the nervous system, the endocrine system and especially on the immune system have generated the hypothesis that might be a relevant factor in the evolution of multiple sclerosis, so high levels of stress may increase the probability of a negative evolution of the disease and worsen quality of life. An 18-month prospective cohort study with a sample of 49 relapsing-remitting multiple sclerosis patients. Perceived stress was measured monthly. Quality of life was evaluated at the beginning and at the end of the study. Stressful life events and their emotional impact, clinical forms of stress (anxiety and depression), perceived social support, controllability, coping strategies and clinical course were measured at the beginning and every 6 month. The results indicated that stress measures and their emotional impact were good predictors of the number of relapses during the 18 month period. The best quality of life predictors were lower anxiety and depression levels, male sex and low number of pseudo-relapses (R2=0,8 and p=0,0005). It is proposed that biopsychosocial care in neurorehabilitation includes psychological interventions aimed t managing stress, its clinical forms and unhelpful detected coping strategies in order to improve the clinical course of the disease and patients’ quality of life ​
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