Prospective study of stress, depression and personality in myasthenia gravis relapses
Anca Bogdan,
Carolina Barnett,
Abdulrahman Ali,
Mohammed AlQwaifly,
Alon Abraham,
Shabber Mannan,
Eduardo Ng,
Vera Bril
Affiliations
Anca Bogdan
Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Division of Neurology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto
Carolina Barnett
Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Division of Neurology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto
Abdulrahman Ali
National Neuroscience Institute, King Fahad Medical City
Mohammed AlQwaifly
Qassim University
Alon Abraham
Neuromuscular Diseases Unit of the Department of Neurology, Tel Aviv Sourasky Medical Center, The Sackler Faculty of Medicine, Tel Aviv University
Shabber Mannan
Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Division of Neurology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto
Eduardo Ng
Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Division of Neurology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto
Vera Bril
Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Division of Neurology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto
Abstract Background Psychopathology and personality traits may influence the course of autoimmune disorders. With this prospective longitudinal cohort study, we aimed to assess personality, stress and depression in myasthenia patients who relapse and those who remain stable or improve (non-relapsers). Method We collected data from 155 consecutive adult patients with confirmed MG attending the Neuromuscular Clinic, Toronto General Hospital, between March 2017 and July 2018, for this study. Patients were assessed at baseline and 6 months, or at the time of MG relapse. At both visits, the patients were assessed clinically and were asked to complete self-administered questionnaires for disease severity, chronic stress and depression. Personality type was assessed at baseline only. Relapsing patients were defined as those patients with MGII score increasing by more than 5.5 points from visit 1 to visit 2. Results Relapsers had higher baseline scores for depression (p = 0.01) and the change in disease severity correlated with the change in depression score (r = 0.2534, p = 0.0015, 95% CI: 0.098 0.3961). Higher levels of stress at baseline and neuroticism predicted higher relapse rates (p = 0.01 and p < .0001, respectively). In the linear regression model, with change of the MGII score as the dependent variable, change in depression scores (p = 0.0004) and age (p = 0.03) predicted change in disease severity. Conclusions Since emotional factors and personality type may influence MG, attention to these factors might improve care in MG patients.
