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Coping wi h Mul iple Scle osis: Reconciling signi ican
aspec s o heal h- ela ed quali y o li e
Jou nal:
AIDS Ca e - Psychology, Heal h & Medicine - Vulne able Child en and
You h S udies
Manusc ip ID
PHM-2021-09-1202.R1
Jou nal Selec ion:
Psychology, Heal h & Medicine
Keywo ds:
Mul iple Scle osis, Coping S a egies, Social Suppo , Heal h Rela ed
Quali y O Li e, isk and p o ec i e Fac o s
URL: h ps://mc.manusc ip cen al.com/ac-phm- cy Email: [email p o ec ed]
Heal h Sciences
This is an Accep ed Manusc ip e sion o he ollowing a icle, accep ed o publica ion in Psychology, Heal h & Medicine: Gil-
González, I., Ma ín-Rod íguez, A., Con ad, R., & Pé ez-San-G ego io, M. Á. (2023). Coping wi h mul iple scle osis: econciling
signi ican aspec s o heal h- ela ed quali y o li e. Psychology, Heal h & Medicine, 28(5), 1167–1180. h ps://
doi.o g/10.1080/13548506.2022.2077395. I is deposi ed unde he e ms o he C ea i e Commons A ibu ion-NonComme cial-
NoDe i a i es License (h p://c ea i ecommons.o g/licenses/by-nc-nd/4.0/), which pe mi s non-comme cial e-use, dis ibu ion,
and ep oduc ion in any medium, p o ided he o iginal wo k is p ope ly ci ed, and is no al e ed, ans o med, o buil upon in any
way
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Coping wi h Mul iple Scle osis: Reconciling signi ican aspec s o
heal h- ela ed quali y o li e
Mul iple scle osis (MS) symp oms and unp edic abili y can damage pa ien well-being. This
s udy is aimed o in es iga e he ela ion be ween sociodemog aphic and clinical cha ac e is ics
and he use o coping s a egies as well as social suppo on heal h- ela ed quali y o li e
(HRQOL). We e alua ed 314 MS ou pa ien s o Vi gen Maca ena Uni e si y Hospi al in
Se illa/Spain (mean age 45 yea s, 67.8% women) wice o e an 18-mon hs ollow up pe iod by
B ie COPE Ques ionnai e (COPE-28), Mul idimensional Scale o Pe cei ed Social Suppo
(MSPSS) and 12-I em Sho Fo m Heal h Su ey (SF-12). Female gende was signi ican ly
ela ed o eligion ( =0.175, p<0.001), sel -dis ac ion ( =0.160, p<0.001) and sel -blame
( =0.131, p<0.05). Age co ela ed posi i ely wi h eligion ( =0.240, p<0.001), and sel -blame
( =0.123, p<0.05). P og essi e MS as well as unc ional impai men (EDSS) showed a posi i e
ela ion wi h denial ( =0.125, p<0.05; =0.150, p<0.001). Longe du a ion since diagnosis was
ela ed o lowe pe cei ed suppo om amily ( =-0.123, p<0.05). EDSS (β = -0.452, p <
0.001) was he s onges nega i e p edic o o physical HRQOL ollowed by age (β = -0.123, p
< 0.001), whe eas amily suppo was a p o ec i e ac o (β = 0.096, p < 0.001). Denial (β=-
0.132, p< 0.05), sel -blame (β=-0.156, p<0.05), emale gende (β=-0.115, p<0.05) and EDSS
(β=-0.108, p<0.05) nega i ely impac ed on men al HRQOL 18 mon hs la e , whe eas posi i e
e aming (β=0.142, p<0.05) was a p o ec i e ac o . Ou s udy could iden i y
sociodemog aphic and clinical a iables associa ed wi h dys unc ional coping s a egies, such as
sel -blame and denial, which speci ically p edic wo se men al HRQOL as opposed o posi i e
e aming. Diminishing dys unc ional coping and suppo ing cogni i e e aming may
con ibu e o imp o e HRQOL in MS.
key wo ds: Mul iple Scle osis; Coping S a egies; Social Suppo ; Heal h Rela ed Quali y o
Li e; isk and p o ec i e Fac o s
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In oduc ion
Coping s a egies play an essen ial ole in adap a ion o mul iple scle osis (MS) and
Ca ne o Con en i e al. (2021) poin ou a nega i e ela ionship be ween maladap i e
coping and HRQOL. Ca e (1997) di ided coping s a egies in o h ee ca ego ies:
p oblem- ocused, emo ion- ocused, and dys unc ional coping. Gene ally, ac i e coping,
p oblem sol ing, planning, posi i e e aming, accep ance, emo ional and ins umen al
social suppo we e ela ed o a highe HRQOL in MS. Whils , a oidance, beha iou al
disengagemen , sel -dis ac ion, denial, emo ion- ocused, sel -c i icism and en ing
we e associa ed wi h lowe HRQOL (Gil-Gonzalez e al., 2020).
Pa icula ly, Bassi e al. (2021) ound a nega i e associa ion be ween a oidance
coping and physical HRQOL. In addi ion, Ce ea e al. (2021) disco e ed a posi i e
associa ion be ween men al HRQOL and p oblem sol ing and a nega i e wi h
emo ional discha ge and passi e coping (Ce ea e al., 2021; K s ić e al., 2021). The
scien i ic li e a u e e ealed ha MS pa ien s use less ac i e and mo e a oidance and
emo ional coping han he gene al popula ion (Ke ama Ka e al., 2019).
In dealing wi h MS, in apsychic and in e pe sonal mechanisms a e closely
in e wined. A s udy by Homayuni e al. (2021) ound ha MS pa ien s desc ibed
coping s a egies and social suppo as HRQOL acili a o s. In ac , social suppo has
been ela ed o imp o emen s ega ding a igue (Mikula e al., 2020), pain (Alphonsus
& D’A cy, 2021), dep ession and anxie y (Hanna & S obe , 2020; Mikula e al., 2020;
Ra ajska e al., 2020), he eby also p o ec ing employmen (Iwanaga e al., 2018). Social
suppo also in luences pa ien s’ a i udes on medica ion selec ion as hey conside
signi ican o he s’ opinions (Visse e al, 2020). In summa y, he e is e idence ha
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di ec ly and/o indi ec ly highe social suppo is ela ed o be e HRQOL (Bassi e al.,
2021; Dȩbska e al., 2020; Gil-González e al., 2020; Ke e e al., 2021; Ra ajska e al.,
2020), while lowe social suppo is ela ed o wo se HRQOL (Cos a e al., 2017;
S obe , 2018).
The p esen s udy aimed a in es iga ing (1) sociodemog aphic and clinical
ac o s unde lying coping s a egies and social suppo in adul s wi h mul iple scle osis
(MS), and (2) he ole o coping s a egies and social suppo as well as
sociodemog aphic and clinical ac o s as p edic o s o quali y o li e in MS o e an 18
mon hs’ ollow-up pe iod.
Me hod
Pa icipan s and p ocedu es
The sample was ec ui ed be ween June 2017 and May 2018 (T1), and Decembe 2018
and Decembe 2019 (T2) a Vi gen de la Maca ena Uni e si y Hospi al in Se illa/Spain.
Inclusion c i e ia we e: (1) con i med MS diagnosis; (2) age o e 18, and (3) men al,
physical and cogni i e capabili y o pa icipa e and sign in o med consen . The s udy
was app o ed by he esponsible E hics Commi ee (0846-N-18).
Ins umen s
Clinical and sociodemog aphic in o ma ion we e collec ed om he medical da a base
and a ques ionnai e.
Coping s a egies
The Spanish e sion o B ie COPE Ques ionnai e (COPE-28) was applied o s udy he
pa ien s use o di e en ac ions in dealing wi h s ess ul si ua ions (Mo án e al., 2010).
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COPE-28 has 28 i ems g ouped in o he ollowing 14 dimensions: (1) accep ance; (2)
emo ional suppo ; (3) humo ; (4) posi i e e aming; (5) eligion; (6) ac i e coping; (7)
ins umen al suppo ; (8) planning; (9) beha io al disengagemen ; (10) denial; (11) sel -
dis ac ion; (l2) sel -blaming; (13) subs ance use; (14) en ing. I ems a e sco ed on a
ou -poin Like scale ( om 0 o 3). Highe sco es indica e g ea e use (Ca e , 1997).
C onbach’s alpha anged om 0.60 o 0.88 o he 14 subscales.
Social Suppo
Pa icipan s pe cep ion o social suppo was measu ed by he Mul idimensional Scale
o Pe cei ed Social Suppo (MSPSS). The MSPSS comp ises 12-i ems sco ed on a 7-
poin Like scale anging om 1 o 7. The o al sco e a ies om 12 o 84 (A echabala
and Mi anda, 2002; Zinne , 1988). C onbach’s alpha in ou sample anged om 0.91 o
0.96 o he subscales.
Heal h ela ed Quali y o li e
The 12-I em Sho Fo m Heal h Su ey (SF-12) consis s o 12 i ems sco ed on a 3 o 5-
poin Like scale. The SF-12 consis s o eigh domains: physical unc ioning, ole-
physical, bodily pain, gene al heal h, i ali y, social unc ioning, ole-emo ional and
men al heal h. Subscales sco es ange om 0 (wo s ) o 100 (bes ). These subscales a e
combined o o m he Physical Componen Summa y Sco e (PCS) and he Men al
Componen Summa y Sco e (MCS) (Vilgau e al., 2008; Wa e e al., 2002). In ou
sample, dimensions C onbach’s alpha anged om 0.70 o 0.96 a T1 and om 0.64 o
0.96 a T2. C onbach’s alpha o he PCS and MCS was 0.92 and 0.88, espec i ely
(Ma uish, 2012).
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S a is ics
Pea son and Spea man co ela ions a e p esen ed o coping s a egies/social suppo
and clinical/demog aphic a iables.
S epwise eg ession analyses iden i y quali y o li e p edic o s and de e mine
hei ela i e con ibu ion. Two mul i a ia e models we e buil wi h MCS and PCS
sco es a T2 as dependen a iables. Sociodemog aphic (gende , age, pa ne ship,
educa ional le el and occupa ion), clinical a iables (EDSS, MS sub ype, mon hs since
diagnosis and mon hs since he ou b eak), coping s a egies and social suppo a T1
we e conside ed as p edic o s.
All es s we e compu ed using SPSS- 26. Signi icance le el was se o p< 0.05.
E ec size coe icien we e calcula ed using G*Powe So wa e. Coe icien s we e
in e p e ed acco ding o Cohen (1988) guidelines; o co ela ions: p ≥ 0.10 small, ≥
0.30 medium, and ≥ 0.50 la ge e ec and in mul iple eg ession: 2 ≥ 0.02 small, ≥ 0.15
medium, and ≥ 0.35 la ge e ec .
Resul s
The inal sample comp ised 314 MS pa ien s (d opou a e 19.69%; see igu e 1).
-Figu e 1-
As can be seen in Table 1, he sample was composed o 213 (67.8%) emales and 101
(32.2%) males. Mean age was 45.31 yea s (±10.77), ange om 19 o 78 yea s. The
p edominan MS ype was emi en 272 (86.6) and mean EDSS sco e was 3.17 (±1.92).
-Table 1-
Sociodemog aphic/clinical a iables and coping s a egies
Female gende co ela ed wi h highe use o sel -dis ac ion ( =0.160, p<0.001), eligion
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( =0.175, p<0.001), and sel -blame ( =0.131, p<0.05). Age also co ela ed posi i ely
wi h eligion ( =0.240, p<0.001), and sel -blame ( =0.123, p<0.05). Highe educa ional
le el was ela ed o a highe use o planning ( =0.167, p<0.001), seeking emo ional
suppo ( =0.119, p<0.05), and en ing ( =0.151, p<0.001). Being unemployed was
ela ed o a lowe use o en ing ( =-0.121, p<0.05) and highe use o denial ( =0.133,
p<0.05) as well as eligion ( =0.112, p<0.05).
P og essi e MS sub ype showed a nega i e ela ion wi h en ing ( =-0.134,
p<0.05) and a posi i e ela ion wi h denial ( =0.125, p<0.05).
Mon hs since diagnosis posi i ely co ela ed wi h sel -blame ( =0.147,
p<0.001), as well as mon hs since he ou b eak ( =0.143, p<0.05), which also co ela ed
nega i ely wi h ac i e coping ( =-0.115, p<0.05).
EDSS was ela ed o a highe use o beha io al disengagemen ( =0.112,
p<0.05), denial ( =0.150, p<0.001), subs ance use ( =0.124, p<0.05), and humo
( =0.120, p<0.05).
The e we e no signi ican co ela ions in ega d o pa ne ship s a us in he use
o coping s a egies.
E ec sizes coe icien s (p) o signi ican co ela ions anged om 0.33 o 0.48,
medium e ec s (Table 2).
- Table 2-
Sociodemog aphic/clinical a iables and pe cei ed social suppo
Age ( =-0.130, p<0.05) and p og essi e MS sub ype ( =-0.114, p<0.05) we e nega i ely
ela ed wi h social suppo om iends (see Table 3).
Being wi hou a pa ne showed a nega i e ela ion wi h social suppo om
signi ican o he s ( =-0.128, p<0.05).
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Highe educa ional le el ( =-0.119, p<0.05) and longe du a ion since diagnosis
( =-0.123, p<0.05) was ela ed o lowe pe cei ed suppo om amily.
Wi h ega d o gende , occupa ion, mon hs since diagnosis ou b eak and EDSS
no signi ican associa ions we e ound wi h social suppo . Fo signi ican esul s
co ela ion e ec sizes (p) we e medium ( om 0.34 o 0.38).
- Table 3-
Physical and men al HRQOL p edic o s
EDSS (β=-0.452, p<0.001) was he s onges nega i e p edic o o PCS ollowed
by age (β=-0.123, p<0.001). Highe EDSS and olde age we e ela ed o lowe PCS 18
mon hs la e . On he con a y, he a iable amily suppo (β=0.096, p<0.001) led o an
inc ease o PCS (Table 4). All a iables oge he accoun ed o 27.4% o PCS a iance,
wi h a la ge e ec size ( 2=0.377).
Denial (β=-0.132, p<0.05), sel -blame (β=-0.156, p<0.05), emale gende (β=-
0.115, p<0.05) and EDSS (β=-0.108, p<0.05) nega i ely impac ed on MCS 18 mon hs
la e , whe eas posi i e e aming (β=0.142, p<0.05) was a p o ec i e ac o . All
a iables in he model oge he explained 10.1% o MCS, wi h small e ec size
( 2=0.112). (See Table 4).
-Table 4-
Discussion
HRQOL in MS depends on a wide spec um o ac o s, which ye ha e o be ully
unde s ood. The p esen s udy explo ed associa ions and p edic i e alue o
sociodemog aphic and clinical ea u es alongside coping s a egies and social suppo
o HRQOL in MS o e an 18 mon hs ollow-up pe iod.
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Sociodemog aphic/clinical a iables and coping s a egies
Female gende posi i ely co ela ed wi h eligion as an emo ion- ocused coping-
s a egy. The endency o emales o use emo ion- ocused coping s a egies in MS is
suppo ed by p e ious esea ches (Holland e al., 2019; Zengin e al., 2017).
Pa icula ly, Zengin e al. (2017) ound emales o use eligion mo e equen ly as a
coping s a egy han men. Clinically e en mo e impo an we ound signi ican
ela ionships wi h he wo dys unc ional s a egies sel -blame and sel -dis ac ion. Olde
age was also ela ed o a highe use o eligion and sel -blame. Ke ama Ka e al.
(2019) discussed ha olde people wi h MS end o use eligion as a coping s a egy.
The gende and age- ela ed endency o sel -blame is signi ican in iew o he
iden i ica ion o possible isk ac o s o maladap i e coping ea ly in he diagnos ic
p ocess.
Highe le el o educa ion was ela ed o a highe use o planning, a p oblem-
ocused s a egy, and seeking emo ional suppo , an emo ion- ocused s a egy. I can be
a gued ha highe educa ed MS pa ien s can use hei knowledge o choose mo e
e ec i e and adap i e s a egies, and make a g ea e use o social suppo (Ke ama Ka
e al. 2019). On he con a y, highe educa ional le el was ela ed o a highe use o
en ing, classi ied as a dys unc ional s a egy (Ca e 1997; Ledesma e al., 2018;
Meye 2001).
Unemploymen was posi i ely ela ed o a highe use o eligion, an emo ion-
ocused coping s a egy (Ca e 1997; Meye 2001) and denial, as well as lowe use o
en ing. Ou esul con i ms p e ious indings indica ing ha unemployed MS pa ien s
end o a mo e emo ion-o ien ed coping s yle (Ke ama Ka e al., 2019), a oidance and
maladap i e s a egies (Holland e al., 2019; Ke ama Ka e al., 2019). The lowe use o
en ing con adic s i .
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Table 1. Clinical and sociodemog aphic cha ac e is ics
T1 Sample N=391
T2 Sample N=314
Gende n (%)
Male
123 (31.5)
101 (32.2)
Female
268 (68.5)
213 (67.8)
Age (M±SD)
45.66±11.13
45.31±10.77
Pa ne ship n (%)
No pa ne
108 (27.6)
85 (27.1)
Pa ne
283 (72.4)
229 (72.9)
Occupa ion n (%)
Employed/In educa ion
135 (34.5)
116 (36.9)
Unemployed
256 (65.5)
198 (63.1)
Educa ional le el n (%)
P ima y educa ion
65 (16.6)
44 (14)
Seconda y educa ion
128 (32.7)
102 (32.5)
Uni e si y o highe
198 (50.6)
168 (53.5)
EDSS (M±SD)
3.38±2.06
3.17±1.92
MS sub ype n (%)
Remi en
326 (83.4)
272 (86.6)
P og essi e
65 (16.6)
42 (13.4)
Mon hs since diagnosis (M±SD)
145.31±89.49
145.68±89.56
Mon hs since ou b eak (M±SD)
184.90±108.47
186.11±111.18
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Table 2. Co ela ions be ween sociodemog aphic and clinical a iables and coping s a egies
Ac i e
Coping
Planning
Ins umen al
Suppo
Emo ional
Suppo
Sel -
dis ac ion
Ven ing
Beha io al
disengagemen
Posi i e
Re aming
Denial
Accep ance
Religion
Subs ance
use
Humo
Sel -
blame
Gende
0.081
0.020
0.045
0.083
0.160**
0.036
0.047
0.040
0.056
0.021
0.175**
0.044
-0.039
0.131*
p
0.28
0.14
0.21
0.28
0.40
0.18
0.22
0.20
0.24
0.14
0.42
0.21
0.20
0.36
Age
0.050
0.025
-0.079
-0.047
0.059
-0.102
0.007
-0.006
0.045
0.073
0.240**
0.030
-0.020
0.123*
p
0.22
0.16
0.28
0.22
0.24
0.32
0.26
0.07
0.21
0.27
0.48
0.17
0.14
0.35
Pa ne ship
0.038
-0.061
0.032
-0.055
0.093
0.029
-0.072
0.077
-0.033
0.072
0.078
0.090
0.022
0.071
p
0.19
0.25
0.18
0.23
0.30
0.17
0.26
0.28
0.18
0.27
0.28
0.30
0.15
0.26
Educa ional
le el
0.021
0.167**
0.090
0.119*
0.009
0.151**
-0.092
-0.028
-0.024
-0.109
-0.004
-0.088
-0.061
-0.022
p
0.14
0.41
0.30
0.35
0.09
0.39
0.99
0.17
0.15
0.33
0.06
0.29
0.25
0.15
Occupa ion
-0.008
-0.031
-0.024
0.002
0.060
-0.121*
0.077
-0.007
0.133*
0.032
0.112*
0.016
-0.055
0.037
p
0.28
0.18
0.15
00.04
0.24
0.35
0.28
0.08
0.36
0.18
0.33
0.13
0.23
0.19
MS Sub ype
0.034
0.036
-0.011
0.017
0.075
-0.134*
0.068
-0.101
0.125*
0.039
0.073
0.095
-0.028
-0.013
p
0.184
0.19
0.10
0.13
0.27
0.37
0.26
0.32
0.36
0.20
0.27
0.30
0.17
0.11
Mon hs
since
diagnosis
-0.095
-0.029
-0.063
-0.073
0.062
-0.071
-0.038
-0.012
-0.092
0.044
0.093
-0.015
-0.020
0.147**
p
0.30
0.17
0.25
0.27
0.24
0.27
0.19
0.11
0.30
0.21
0.30
0.12
0.14
0.38
Mon hs since
ou b eak
-0.115*
-0.069
-0.050
-0.005
0.034
-0.101
0.036
-0.038
-0.044
0.028
0.084
-0.033
-0.041
0.143*
p
0.34
0.26
0.22
0.07
0.18
0.31
0.19
0.19
0.20
0.16
0.28
0.18
0.20
0.38
EDSS
-0.043
0.001
-0.065
-0.017
0.091
-0.045
0.112*
-0.003
0.150**
0.030
0.027
0.124*
0.120*
0.059
p
0.20
0.03
0.25
0.13
0.30
0.21
0.33
0.05
0.39
0.17
0.16
0.35
0.34
0.24
EDSS, Expanded Disabili y S a us Scale *p< 0.05, **p<0.001, p, e ec size: ≥ 0.10 small, ≥ 0.30 medium, ≥ 0.50 la ge
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Table 3. Co ela ions be ween sociodemog aphic and clinical a iables and pe cei ed
social suppo
EDSS, Expanded Disabili y S a us Scale *p< 0.05, **p<0.001, p, e ec size: ≥0.10 small,
≥0.30 medium, ≥0.50 la ge
Family
F iends
Signi ican
O he s
To al Sco e
Gende
-0.029
-0.044
-0.064
-0.062
p
0.17
0.20
0.25
0.25
Age
-0.042
-0.130*
-0.078
-0.106
p
0.20
0.36
0.27
0.32
Pa ne ship
-0.098
0.033
-0.128*
-0.105
p
0.31
0.18
0.36
0.32
Educa ional le el
-0.119*
-0.072
-0.102
-0.074
p
0.34
00.26
0.31
0.27
Occupa ion
0.065
-0.070
0.102
-0.040
p
0.25
0.26
0.31
0.20
MS Sub ype
0.052
-0.114*
0.090
-0.068
p
0.22
0.38
0.30
0.26
Mon hs since diagnosis
-0.123*
-0.077
-0.039
-0.101
p
0.35
0.27
0.19
0.31
Mon hs since ou b eak
-0.074
-0.055
0.008
-0.053
p
0.27
0.23
0.08
0.23
EDSS
-0.081
-0.103
0.010
-0.077
p
0.28
0.32
0.01
0.27
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Table 4. Physical and men al HRQL Mul iple linea eg ession models
*p<0.05, **p<0.001, §MSPSS Family Suppo Sco e
Dependen a iable physical HRQOL (PCS)
F
R2
R2adj
B
SE.B
β
1-β
2
Model 1
104.556
(1,312)
0.251**
0.249**
54.737**
1.057
1
0.335
EDSS
-2.912**
0.285
-0.501
Model 2
56.012 (2,311)
0.265**
0.260**
59.839**
2.357
1
0.360
EDSS
-2.668**
0.300
-0.459
Age
-0.130*
0.054
-0.125
Model 3
39.010 (3,310)
0.274**
0.267**
55.446**
3.224
1
0.377
EDSS
-2.626**
0.299
-0.452
Age
-0.128*
0.053
-0.123
Family§
0.696*
0.350
0.096
Dependen a iable men al HRQOL (MCS)
F
R2
R2adj
B
SE.B
β
1-β
2
Model 1
11.736 (1,312)
0.036*
0.033*
48.548**
0.752
0.92
0.037
Denial
-3.477**
1.015
-0.190
Model 2
9.557 (2,311)
0.058*
0.052*
50.401**
1.017
Denial
-3.111*
1.014
-0.170
0.98
0.061
Sel -blame
-1.737*
0.650
-0.148
Model 3
8.54 (3,310)
0.076*
0.067*
48.017**
1.391
0.99
0.082
Denial
-2.770*
1.015
-0.152
Sel -blame
-2.082*
0.659
-0.178
Posi i e
Re aming
1.699*
0.683
0.140
Model 4
8.538 (4,309)
0.089*
0.078*
52.506**
2.537
0.99
0.097
Denial
-2.702*
1.010
-0.148
Sel -blame
-1.872*
0.663
-0.160
Posi i e
Re aming
1.716*
0.680
0.141
Gende
-2.849*
1.350
-0.116
Model 5
6.910 (5,308)
0.101*
0.086*
54.341**
2.691
1
0.112
Denial
-2.416*
1.016
-0.132
Sel -blame
-1.825*
0.660
-0.156
Posi i e
Re aming
1.722*
0.676
0.142
Gende
-2.829*
1.344
-0.115
EDSS
-0.645
0.326
-0.108
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Figu e 1. S udy low-cha .
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Table 1. Clinical and sociodemog aphic cha ac e is ics
T1 Sample N=391
T2 Sample N=314
Gende n (%)
Male
123 (31.5)
101 (32.2)
Female
268 (68.5)
213 (67.8)
Age (M±SD)
45.66±11.13
45.31±10.77
Pa ne ship n (%)
No pa ne
108 (27.6)
85 (27.1)
Pa ne
283 (72.4)
229 (72.9)
Occupa ion n (%)
Employed/In educa ion
135 (34.5)
116 (36.9)
Unemployed
256 (65.5)
198 (63.1)
Educa ional le el n (%)
P ima y educa ion
65 (16.6)
44 (14)
Seconda y educa ion
128 (32.7)
102 (32.5)
Uni e si y o highe
198 (50.6)
168 (53.5)
EDSS (M±SD)
3.38±2.06
3.17±1.92
MS sub ype n (%)
Remi en
326 (83.4)
272 (86.6)
P og essi e
65 (16.6)
42 (13.4)
Mon hs since diagnosis (M±SD)
145.31±89.49
145.68±89.56
Mon hs since ou b eak (M±SD)
184.90±108.47
186.11±111.18
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