Clin Rehabil 2001 Dec;15(6):657-68
Nicholl CR, Lincoln NB, Francis
VM, Stephan TF.
Department of Clinical Psychology,
Central Notts Healthcare NHS Trust Headquarters and School of Psychology,
University of Nottingham, UK.
OBJECTIVE:
To investigate the occurrence of
emotional problems in multiple sclerosis (MS) patients. The utility of
rating scales used to measure such problems was studied to make recommendations
for clinical practice.
DESIGN:
Questionnaires were both sent by
post and completed with an assistant psychologist at a home visit.
SUBJECTS:
Ninety-six MS patients in contact
with a rehabilitation consultant.
MEASURES:
Patients were assessed using the
Guy's Neurological Disability Scale (GNDS), Extended Activities of Daily
Living Scale (EADL), Hospital Anxiety and Depression Scale (HAD), Beck
Anxiety and Depression Scales (BAI, BDI), Clinical Outcomes in Routine
Evaluation Measure (CORE) and the Brief Symptom Inventory (BSI).
RESULTS:
Rates of anxiety and depression ranged
from 16% to 48% according to the measures used. All mood scales were highly
significantly correlated with each other. Disability as measured by the
GNDS, but not the EADL, was significantly correlated with all mood measures.
Kappa values showed poor correspondence in the classification of cases.
Receiver operating characteristic curves indicated an optimum cut-off point
of 7/8 on the HAD and 2/3 on the General Health Questionnaire (GHQ-12).
CONCLUSIONS:
Rates of emotional problems were
low given the highly disabled population studied. The HAD was relatively
insensitive in comparison with the BAI and BDI. The GHQ-12 was sensitive
and therefore recommended as a short screening measure. An alternative
short screen, 'Emotional GNDS', was proposed.
PMID: 11777096 [PubMed - in process]