Symptom cluster and quality of life: preliminary evidence in multiple sclerosis

Abstract

This study examined the symptom cluster of fatigue, pain, and depression as a correlate of reduced quality of life (QOL) in individuals with multiple sclerosis (MS). The sample included 291 individuals with a definite diagnosis of MS who were enrolled in a 6-month longitudinal study of physical activity and QOL. The participants completed baseline measures of fatigue, depression, and pain and follow-up measures of QOL. Cluster analysis initially identified three subgroups differing in experiences of fatigue, depression, and pain, and analysis of variance then indicated that the three subgroups differed in QOL. The subgroup with lowest scores on all three symptoms had the highest QOL, whereas the subgroup with the highest scores on the symptoms had the worst QOL. Such findings provide preliminary support for fatigue, pain, and depression as a symptom cluster that correlates with reduced QOL in persons with MS.

Figures

Figure 1

Standardized mean scores and standard errors for the measures of fatigue, depression, and pain based on the low, moderate, and high symptom clusters identified in the cluster analysis with the sample of 291 individuals with multiple sclerosis. Note: FSS = Fatigue Severity Scale; HADS-D = Hospital Anxiety and Depression Scale-Depression Subscale; MPQ = Short-form of McGill Pain Questionnaire.

Figure 2

Observed mean scores and standard errors for the measures of quality of life based on the sub-groups of low, moderate, and high symptom experiences identified in the cluster analysis with the sample of 291 individuals with multiple sclerosis. Note: LMSQOL = Leed’s Multiple Sclerosis Quality of Life scale; SWLS = Satisfaction with Life Scale.