Profile of depression, experienced distress and capacity for coping with stress in multiple sclerosis patients--a different perspective.

Multiple sclerosis (MS) can result in significant changes in psychological functioning. Depression and cognitive deficits are commonly present. In addition personality changes have been described. A growing body of research is showing negative impact of psychological stress on disease course. Our study focused on the profile of depression, capacity for coping with stress and experienced distress in patients with MS measured by a performance based method for personality assessment-the Rorschach Inkblot Method (RIM). We included 95 patients with MS and 44 healthy controls. RIM was used with all participants and was scored by the Exner Comprehensive system. Compared to healthy controls MS patients had statistically significantly lower capacity for coping with stress, complexity of information processing, body image, willingness to process emotional stimulation and interpersonal interest. Surprisingly patients had lower experienced distress than controls. We propose that the profile of depression in advanced MS disease might be better described in terms of negative symptoms such as emotional withdrawal and apathy and less with the profile of positive symptoms such as rumination and worry. RIM variables were not significantly associated with the EDSS. Interventions from which patients could benefit are discussed.