Perceived discrimination in patients with multiple sclerosis and depressive symptomatology.

BACKGROUND: Multiple Sclerosis is the central nervous system's most common demyelinating disease and the second leading cause of neurological disability in young adults. Its natural development involves physical and cognitive impairment. Patients commonly perceive discrimination against them, regardless of its occurrence, accepting it as an inherent part of the disease. OBJECTIVE: This study aimed to determine the association between perceived discrimination and the depressive symptoms and physical disability present in patients diagnosed with multiple sclerosis, treated at the Demyelinating Diseases Clinic of the National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez. METHODS: A cross-sectional study was conducted in 98 patients diagnosed with multiple sclerosis. Demographic and clinical variables were obtained through clinical interviews. The severity of the disease was determined using the Extended Disability Status Scale (EDSS), depressive symptoms were assessed with the Beck Depression Inventory (BDI), and perceived discrimination was rated using the King Internalized Stigma Scale. RESULTS: The studied sample's mean age was 36.3 years, schooling 13.6 years, symptoms onset was at 26.2 years (with a delay in diagnosis of 3.2 years), and a disease evolution of 10.9 years. 71.4% were single; 52% had an unpaid work activity and 57.1% were women. The EDSS average was 3.5 points; 24.5% presented moderate to severe depressive symptoms and 53.1% referred perceived discrimination. CONCLUSIONS: Perceived discrimination in patients with multiple sclerosis was associated with earlier disease onset, depressive symptoms, and the lack of caregivers. Medical care and life quality improvement for this vulnerable group require greater education regarding the disease and the establishment of patient support programs.

Estudio comparativo de la personalidad del paciente con dolor lumbar crónico y sujetos control mediante el uso del Inventario de Temperamento y Carácter / No disponible

La personalidad impacta sobre la forma en la que las personas con lumbalgia crónica enfrentan el dolor. Se ha identificado la relación entre ciertas características de la personalidad con el desarrollo y mantenimiento del dolor crónico. Los estudios sobre lumbalgia crónica y la personalidad mediante el modelo psicobiológico de la personalidad son escasos y tendrían un valor heurístico para facilitar el desarrollo de investigación en este campo. Objetivos: comparar las dimensiones de temperamento y carácter entre pacientes con lumbalgia crónica y sujetos control; y comparar las características de personalidad entre pacientes con dolor de intensidad leve y aquellos con dolor de intensidad moderada/severa. Método: se reclutaron 46 pacientes diagnosticados de lumbalgia crónica del Hospital General de México y 46 sujetos controles pareados por género y edad. Se evaluaron las características clínicas de la lumbalgia crónica. Las dimensiones de la personalidad fueron evaluadas mediante el Inventario de Temperamento y Carácter (ITC). Resultados: los pacientes mostraron una mayor puntuación en la dimensión de temperamento "búsqueda de la novedad" (NS) y menor puntuación en la "evitación al daño" (HA); así como menor puntuación en la dimensión de "cooperatividad" (CO). Los pacientes con mayor intensidad de dolor mostraron una tendencia a una mayor HA. Discusión: los resultados apoyan el modelo de atribución temor/evitación que asume que las interpretaciones catastróficas del dolor, fomentan el miedo y las conductas evitativas, empeorando el padecimiento. El estudio de la personalidad en pacientes con lumbalgia crónica brinda nuevos conocimientos sobre las áreas de intervención psicosocial requeridas por estos pacientes (AU)

Personality has an important role in the way patients with chronic low back pain face pain. Some personality features have been associated to the development and the maintenance of chronic pain. Studies of chronic low back pain and personality according to the psychobiological model of personality are scarce and will have a heuristic value to promote research in this field. Objectives: to compare temperament and character dimensions between patients with chronic low back pain and control subjects; ant to compare personality features between patients with low intensity pain and those with pain of moderate/severe intensity. Method: a total of 46 patients with chronic low back pain were recruited from the Hospital General de México and were matched by age and gender with 46 control subjects. Clinical features of the disorder were assessed. Personality dimensions were evaluated with the Temperament and Character Inventory (TCI). Results: patients exhibited higher scores on the temperament dimension "novelty seeking" (NS) and lower scores on "harm avoidance" (HA), also, lower scores were found on the character dimension "cooperativeness" (CO). Patients with moderate/severe pain reported a tendency to a higher HA. Discussion: our results support the attribution fear/avoidance model which presumes that catastrophic interpretations of pain give rise to fear and avoidant behaviors which worsens the pain problem. The study of personality in patients with chronic low back pain gives new information related to the psychosocialinterventions required for these patients (AU)