Studies on Mental Health, Quality of Life in Multiple Sclerosis Lack Patient Diversity

A lack of diversity in study samples of patients with multiple sclerosis (MS) has been observed, in particular, among Hispanic/Latinx/e (Hispanic) and Black/African American individuals with the disease, according to study results presented at the 2023 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, held from May 31 to June 3 in Aurora, Colorado.

It is well known that mental health issues, including depression and anxiety, are often reported among patients with MS. In these individuals, quality of life (QOL) has been associated with mental health status as well. Due to the lack of diversity seen in study participants, key information relative to the experiences of all individuals with MS is being overlooked.

For the study, researchers obtained data from the current literature regarding the psychosocial functioning of Hispanic and Black/African American individuals with MS residing in the US vs Latin America. They utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for performing scoping reviews. The following exclusion criteria applied:

• Reviews or meta-analyses
• Studies that were conducted outside the United States or Latin American
• Studies that did not comprise Hispanic and/or Black/African American individuals with MS
• Non-English or Spanish articles

Initially, the literature search yielded a total of 2867 abstracts for screening, with 179 full-text articles ultimately evaluated for their eligibility. Following full-text screening, 39 articles were selected for inclusion in the review.

All of the studies had been performed in the US or several countries in Latin America. Overall, about 23% of the studies included Black/African American patients with MS; all of these studies had been conducted in the US.

Mixed study results were reported with respect to depression among Black/African American individuals with MS in the US. In fact, in many of the studies, fewer mental health difficulties were seen in Black/African American patients with MS compared with White patients with MS. In 1 study, however, Black/African Americans with MS compared with their White counterparts were nearly twice as likely to be underdiagnosed with a psychiatric disorder. Additionally, poorer QOL among Black/African American individuals with MS was linked to greater symptom severity and more psychosocial distress.

In the US, Hispanic individuals with MS as compared with White patients with MS, reported at least mild symptoms of depression. Further, these patients indicated that depression, physical symptoms, and barriers to care were all related to their QOL.

Outside the US, compared with control individuals, Hispanic patients with MS had significantly higher levels of depression and anxiety. Patients’ loss of independent functioning and their level of disability were associated with QOL.

“It is evident that mental health and QOL are important areas to address in non-White persons with MS,” the researchers noted, “and future research should make it a priority to focus on historically minoritized persons with MS, especially in the context of social/systemic factors (eg, racism),” they concluded.

This article originally appeared on Neurology Advisor