Mental health status of relapsing-remitting multiple sclerosis Italian patients returning to work soon after the easing of lockdown during COVID-19 pandemic: A monocentric experience

Background: The prolonged lockdown related to COVID-19 pandemic determined disruption of lifestyle and social isolation. Methods: To assess the mental health status of Relapsing-Remitting Multiple Sclerosis (RRMS) patients regularly followed at the MS center of Catania (Italy) and returning to work after the easing of lockdown during COVID-19 pandemic. Then, to identify any variables associated to psychological distress. RRMS patients returning to work during the COVID-19 pandemic were invited to answer a telephonic interview consisting of the administration of the Short-Screening-Scale for DSM IV (SSS-DSM-IV), the Depression, Anxiety, Stress Scale21 (DASS-21) and the Insomnia Severity Index (ISI). Other information was extracted from electronic medical records. Results: Valid and complete interviews were obtained from 432 patients (response rate 64.3%). Out of them, 277 (64.1%) were female, mean age 40.4 (SD 12.4) years. One-hundred thirty-seven (31.7%) RRMS patients received a score >= 4 at the SSS-DSM-IV, indicating clinically significant PTSD-like symptoms. About DASS-21, moderate to-severe anxiety was reported by 210 RRMS patients (48.6%), moderate-to-severe depression, and moderate-to severe stress were respectively reported by 95 (22%) and 220 (50.9%) RRMS patients. Insomnia was reported by 128 patients (29.6%). Factors associated with major severity of symptoms were: marital status, previous diagnosis of mood disorders, switching/starting Disease-Modifying Therapies in the last 12 months, and a higher level of disability measured with Expanded Disability Status Scale (for all, p<.05). Conclusions: Our findings highlight the need to provide psychological support to MS patients facing the delicate phase of returning to work and to normal activities.