Academic journal article Journal of Rehabilitation Research & Development

Correlations of Perceived Deficits Questionnaire of Multiple Sclerosis Quality of Life Inventory with Beck Depression Inventory and Neuropsychological Tests

Academic journal article Journal of Rehabilitation Research & Development

Correlations of Perceived Deficits Questionnaire of Multiple Sclerosis Quality of Life Inventory with Beck Depression Inventory and Neuropsychological Tests

Article excerpt

Abstract--The Perceived Deficits Questionnaire (PDQ) is a part of the Multiple Sclerosis (MS) Quality of Life Inventory that assesses self-perceived cognitive difficulties. We used baseline data from 49 MS subjects participating in a clinical trial to evaluate the correlation of the PDQ with two measures of cognitive impairment, the Paced Auditory Serial Addition Test (PASAT) and the California Verbal Learning Test, 2nd edition (CVLT-II), total score, and one measure of depression, the Beck Depression Inventory-Amended (BDI-IA). The PDQ correlated significantly (r = 0.42; 95% confidence interval [CI], 0.15 to 0.62; p = 0.003) with the BDI-IA scores but not with either the PASAT (r = -0.22; 95% CI, - 0.48 to 0.06; p = 0.2) or the CVLT-II total (r = -0.17; 95% CI, -0.43 to 0.12; p = 0.25). A subset of 38 of these subjects who scored worse than 0.5 standard deviation below the mean on the PASAT or CVLT-II received a more extensive neuropsychological battery of tests. No significant correlations were found between any of these tests and the PDQ. These results suggest that self-perceived cognitive dysfunction relates more to depression than to objective cognitive dysfunction.

Key words: Beck Depression Inventory, California Verbal Learning Test, cognition disorders, depression, multiple sclerosis, neuropsychological tests, Paced Auditory Serial Addition Test, Perceived Deficits Questionnaire, quality of life, questionnaires.

INTRODUCTION

Patients with multiple sclerosis (MS) can experience deterioration in their quality of life (QOL) in physical, cognitive, and emotional domains. Instruments that measure the impact of MS in health-related QOL have been developed to capture the impact of the disease on other domains besides physical disability. The prevalence of cognitive dysfunction in people with MS has been estimated to be between 45 and 65 percent [1-2]. Cognitive impairment in people with MS is associated with decreased employment and social interactions [3]. Instruments for measuring QOL in MS should include useful scales that measure the impact of cognitive impairment. The MS QOL Inventory (MSQLI) is a modular MS-specific health-related QOL instrument consisting of a widely used generic measure, the 36-item short form Medical Outcomes Study Health Status Questionnaire that is supplemented by nine symptom-specific measures [4]. The Perceived Deficits Questionnaire (PDQ) is a part of the MSQLI and measures self-reported symptoms of psychological impairment. The MSQLI has been shown to have internal reliability and construct validity in a large sample of North American subjects [4]. To understand the contributions of objective impairment in standard neuropsychological tests and depression to self-perception of cognitive deficits, we used baseline data of 49 subjects to evaluate the correlation of the PDQ with the Beck Depression Inventory-Amended (BDI-IA) and with two neuropsychological tests, the Paced Auditory Serial Addition Test (PASAT) and the total score from the California Verbal Learning Test, 2nd edition (CVLT-II). We selected the PASAT and the CVLT-II total score because these two tests measure sustained attention and memory, respectively. These domains are frequently impaired in people with MS [1-2]. The PASAT has also been routinely used in clinical trials in MS and is part of the MS Functional Composite. Both tests are easy to administer and have good population norms. In a subgroup of 38 subjects with below-average performance on the CVLT-II total score or the PASAT, we also determined the correlation of the PDQ with a more extensive battery of tests that included the Controlled Oral Word Association Test (COWAT), the Symbol Digit Modalities Test (SDMT), an adapted version of the useful field of view (UFOV), and the University of Victoria version of the Stroop color-word test (Stroop). We chose the SDMT and the Stroop as additional measures of attention and the COWAT as a measure of verbal fluency because performance on all three tests is frequently impaired in MS [1]. …

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