Background: The lifetime prevalence of depression in people with multiple sclerosis (MS) is approximately 50% compared with around 16% in the general population. There is a relationship between depression and quality of life in people with MS and evidence that depression may contribute to disease progression. Methods: This cross-sectional pilot study assessed the association between depression and regional brain atrophy, including amygdala and hippocampal volume. Forty-nine participants with MS recruited through a hospital MS clinic were administered the Center for Epidemiological Studies Depression Scale Revised (CESD-R) to investigate whether higher endorsement on the items depressive affect and interpersonal symptoms were associated with volumetric magnetic resonance imaging measurements of hippocampal and amygdala atrophy. Results: Regression analysis revealed an association between depression-related interpersonal symptoms and right amygdala volume. No association was found between depression and hippocampal volume. Conclusions: These results provide preliminary support for a unilateral, biologically based relationship between the right amygdala and characteristic interpersonal depressive symptoms expressed by people with MS and add to the growing body of literature implicating regional brain atrophy in MS-associated depression. Given that the interpersonal subcomponent of the CESD-R measures social functioning, and the neural networks in the amygdala are known to be implicated in processing social stimuli, this research suggests that targeted diagnosis and treatments for depression in people with MS may be particularly beneficial in this population. Further confirmatory research of this relationship is required.

Background: Maximizing quality of life (QOL) for people with multiple sclerosis (MS) is a primary focus of health care management professionals. Research has shown a relationship between QOL and a person's coping style and that coping provides an indirect link between cognition and stress, depression, and anxiety in MS. This research assessed whether coping moderates or mediates the relationship between executive function and QOL in people with MS. Methods: We assessed 107 people with relapsing-remitting (n = 83) or secondary progressive (n = 24) MS using executive function tasks and self-report coping and QOL inventories. Results: Coping strategies that mediated the relationship between executive function and QOL in people with MS included behavioral disengagement, acceptance, growth, and religion, while moderating strategies were denial, active, religion, adaptive, and total coping indices. Less cognitively demanding coping strategies that were related to increased QOL in people with poorer executive function included acceptance, growth, and religion, and maladaptive strategies associated with poorer QOL were behavioral disengagement and denial. Conclusions: These results suggest that lessening avoidant coping strategies and strengthening use of less cognitively demanding adaptive coping strategies may improve QOL in people with MS who experience deficits in executive function. Consideration should be given to the development of psychoeducation and interventions with this focus.

Background: The experience of psychological distress is prevalent in people with multiple sclerosis (MS), including high levels of stress, anxiety, and depression. It has been shown that people with MS use less adaptive coping compared with healthy individuals. This study examined the ability of coping strategies to predict maladaptive and adaptive psychosocial outcomes across areas of stress, depression, anxiety, and quality of life (QOL) in people with MS. Methods: 107 people with MS completed measures of depression (Beck Depression Inventory–II), anxiety (State-Trait Anxiety Inventory), QOL (Multiple Sclerosis Quality of Life–54), stress (Daily Hassles Scale), and coping (COPE inventory). Results: Consistent with expectations, depression, frequency of stress, trait anxiety, and mental health QOL were predicted by adaptive and maladaptive coping styles. Severity of stressful events was predicted by maladaptive, but not adaptive, coping styles. Depression and mental health QOL were most prominently connected to coping use. Emotional preoccupation and venting showed the strongest relationship with poorer psychosocial outcomes, whereas positive reinterpretation and growth seemed to be most beneficial. Conclusions: The results of this study highlight the importance of intervention programs targeting specific coping strategies to enhance psychosocial adjustment for people with MS.