Depression and Age at First Neurology Appointment Associated with Receipt of Behavioral Medicine Services Within 1 Year in a Multiple Sclerosis Population.

BACKGROUND: Patients with multiple sclerosis (MS) newly seen by a neurologist may benefit from early psychological intervention owing to the reciprocal relationship between stress and disease progression. However, it is uncertain what factors contribute to patients' receiving these services.

METHODS: Logistic regression analysis of prospectively gathered data evaluated how demographic and disease characteristics and emotional/physical health factors contributed to referral to receive behavioral medicine (BM) services within 1 year of their first neurology appointment at the Mellen Center for Multiple Sclerosis at the Cleveland Clinic. Survival analyses then evaluated whether this resulted in earlier receipt of services.

RESULTS: Although many factors were associated with receiving BM services during univariate analyses (age, race, marital status, years since MS onset, depression, stress, and quality of life), when considering multivariable interactions, only two variables remained significant: age (odds ratio [OR] = 0.86, 95% confidence interval [CI], 0.80-0.92) and depression (OR = 1.56, 95% CI, 1.39-1.75). Survival analyses did not show differences in time to BM services for stratifications of age or depression scores.

CONCLUSIONS: Younger patients and patients with more severe depression were more likely to receive BM services within 1 year of their first neurology appointment. Future research will focus on evaluating whether these are also the patients in greatest need of services or whether they are simply more open to receiving them.