By Dr Saùl Reyes, Clinical Training Fellow, The Royal London Hospital
MS Specialists MasterClass 6, 2019


Background: 

Social capital (SC) refers to the many resources derived from the cooperation between individuals and groups.

SC partially explains how social conditions influence health and mortality. The effect of SC on the outcomes of people with multiple sclerosis (pwMS) has not been explored before.


Objective: 

To investigate the effect of SC on the physical and psychological impact of MS.


Methods: 

A cross-sectional study was conducted among pwMS at The Royal London Hospital, London, UK. Participants completed an online survey including the MS Impact Scale (MSIS-29), the Hospital Anxiety and Depression Scale (HADS), the self-reported Expanded Disability Status Scale (EDSS) and a SC question set.

The SC questionnaire assessed social networks, trust and norms, personal relationships and civic engagement. Kendall’s tau correlation test was performed to measure the correlation between SC and MSIS-29 and multiple linear regressions were conducted to find the best outcome prediction model.


Results: 

  • 236 patients participated in the study.
  • Median age was 43.5 years (IQR 35-52). 168 (71.2%) were female and 180 (76.3%) had relapsing-remitting MS.
  • Abnormal HADS scores (≥ 8/21) for anxiety and depression were seen in 133 (56.4%) and 72 (30.5%) patients, respectively.
  • Median scores were 23.7 (IQR 8.8-57.5) for the physical and 38.9 (IQR 16.7-55.6) for the psychological scales of the MSIS-29.
  • Total SC scores were significantly correlated with MSIS-29 physical (τb=-0.09, p=0.02) and psychological scores (τb=-0.23, p<0.001).
  • After adjusting for possible confounding variables, total SC scores had a significant effect on MSIS-29 psychological score (β=-1.97, SE=0.44; p<0.001).

Conclusions: 

Higher levels of SC were associated with lower self-rated psychological impact of MS. Emerging evidence on SC and MS should be translated into interventions for health-promoting purposes.


Keywords: 

  • Multiple sclerosis
  • Social capital
  • Social determinants of health
  • Social support
  • Patient reported outcome measures