The influence of trait mindfulness on depression in multiple sclerosis: potential implications for treatment.

PURPOSE: This study seeks to add to existing literature on depression and illness intrusiveness in chronic disorders by examining, (1) how the perceived intrusiveness of multiple sclerosis (MS) leads to depression, (2) and the mediating role trait mindfulness plays in this relationship METHODS: Participants (N = 755) were persons with MS (PwMS) recruited through the North American Research Committee on MS (NARCOMS) registry (a larger study). Participants completed the Illness Intrusiveness Ratings Scale, the Hospital Anxiety and Depression Scale and the Mindful Attention Awareness Scale. A mediation model assessed if trait mindfulness mediates the relationship between illness intrusiveness and depression RESULTS: Illness intrusiveness predicted trait mindfulness (a = - 4.54; p < .001), trait mindfulness predicted depression (b = - .04; p < .001); there was a direct effect of illness intrusiveness on depression (c' = 2.53; p < .001) and an indirect effect on depression (ab = .17, 95% BCa CI [.10, .25]) when trait mindfulness was in the model, which represented a medium size effect, R2med = .10 [95% CI .07, .14] CONCLUSION: Trait mindfulness mediates the relationship between illness intrusiveness and depression in PwMS. Providers could provide psychoeducation on the benefits of mindfulness and mindfulness-based interventions.

Age-related comparisons of people with multiple sclerosis: demographic, disease, and treatment characteristics.

OBJECTIVE: To determine if the demographic characteristics and health care needs of younger people with MS differ from older people with MS. PARTICIPANTS: The study analyzed enrollment data from the NARCOMS Registry to compare 1,987 younger adults with MS (30 years and younger) to 29,245 other adults with MS (over 30 years). METHODS: Analyses of the NARCOMS data focused on descriptive characteristics of these adults with MS, using a t-test to identify any statistically significant age-related differences in means and a chi-squared test to identify any statistically significant age-related differences in proportions. RESULTS: A significantly larger proportion of younger adults with MS were female and African American compared to other adults with MS. We found significant age-related differences in the expression of physical disability domains but few significant age-related differences in symptoms of depression. We also observed significant age-related differences in the utilization of health providers, with larger proportions of other adults with MS treated by internists, urologists, rehabilitation specialists, and physical and occupational therapists. CONCLUSIONS: The comprehensive care of younger adults with MS should include monitoring for mental health conditions and the availability of mental health services.

A cross-sectional study of bone health in multiple sclerosis.

BACKGROUND: Osteoporosis is an important risk factor for fragility fractures. Although osteoporosis is considered common in multiple sclerosis (MS), few previous studies focused on fractures in MS. OBJECTIVE: Using the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry, we investigated the frequency of osteoporosis, fractures, and clinical risk factors for fracture in MS. METHODS: In 2007, 9,346 NARCOMS participants reported fractures and clinical risk factors for fractures including history of osteoporosis or osteopenia (low bone mass), sedentary level of physical activity, falls in the last year, current smoking status, family history of osteoporosis, and impaired mobility. RESULTS: Among responders, 2,501 (27.2%) reported low bone mass. More than 15% of responders reported a history of fracture after age 13 years (n = 1,482). Among those reporting fractures, 685 (46.2%) reported multiple fractures, while 522 (35.2%) reported a wrist fracture, 165 (11.1%) reported a vertebral fracture, and 100 (7.4%) reported a hip fracture. Excluding age, 1,413 (15.1%) participants had 1 clinical risk factor for fracture, 2,341 (25.0%) had 2, and 5,393 (57.7%) had 3 or more. Among participants with a history of fracture, 746 (55%) reported taking calcium supplements, 858 (68.8%) reported taking vitamin D supplements or a multivitamin with vitamin D, and 334 (22.5%) reported taking a bisphosphonate. CONCLUSION: Patients with multiple sclerosis (MS) often have multiple risk factors for osteoporotic fractures. Many patients with MS with low bone mass or previous fractures are not taking supplemental calcium or vitamin D, suggesting a potential area of improvement in care.