Short report: assessment of coping strategies in patients with neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis.

Neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) are disabling neurological diseases with significant emotional distresses. To better deal with these diseases, patients need to adopt coping strategies. Identifying coping strategies is important in our understanding of the disease burden and management. However, no one to the best of our knowledge has studied coping strategies in NMOSD patients worldwide. We performed this study to evaluate coping strategies in NMOSD and MS patients compared to healthy controls. We assessed coping strategies using Coping Orientation for Problem Experiences (COPE) inventory. Demographic and clinical characteristics were gathered as well. Thirty NMOSD patients, 76 MS patients, and 50 healthy controls were recruited. NMOSD and MS patients adopted acceptance and behavioral disengagement strategies more often compared to healthy control. Furthermore, NMOSD cases were more prone to using mental disengagement strategy. Both NMOSD and MS cases were less prone to substance use. In NMOSD group, patients with basic education had higher scores of focus on and venting emotions compared to those with advance education. No relationship between coping strategies and demographic and clinical characteristics was observed. We found almost similar patterns of coping in NMOSD and MS. NMOSD patients showed utilization of maladaptive coping strategies with more frequent use of mental and behavioral disengagement. We suggest a multidisciplinary approach to manage these patients.

Higher Disease and Pain Severity and Fatigue and Lower Balance Skills Are Associated with Higher Prevalence of Falling among Individuals with the Inflammatory Disease of Neuromyelitis Optica Spectrum Disorder (NMOSD).

BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) is a chronic inflammatory and autoimmune disorder that is associated with impaired vision, sensory loss, pain, fatigue, and spasms in the upper and lower limbs. Typically, persons with this disorder are also at higher risks of falls. Given this, the aims of the study were to compare the prevalence rates of falling for NMOSD cases and healthy controls (HCs), and to predict falling in the former group based on sociodemographic, psychological, and illness-related factors. METHOD: A total of 95 adults with NMOSD (Mean age = 34.89 years; 70.5% females) and 100 matched HCs took part in the study. All participants completed a series of questionnaires covering sociodemographic information and falling rates. The NMOSD individuals also reported on disease duration, pain, fatigue, and fear of falling, while their balance performance was objectively assessed. RESULTS: Compared to healthy controls, the NMOSD cases had a 2.5-fold higher risk of falling. In this latter group, higher scores for pain, fatigue, fear of falling, and higher EDSS scores were distinguished between fallers and non-fallers, and objective balance skills had no predictive value. CONCLUSIONS: Compared to healthy controls, NMOSD sufferers had a 2.5-fold higher risk of experiencing falls. In this group, disease impairments (EDSS, fatigue, pain) predicted falling. Specific interventions such as regular resistance training might reduce the risk of falling.